Individual provider Active NPI

Amanda Gail Williams, PT, DPT

  • Physical Therapist
  • Little Rock, AR
National Provider Identifier
1104259563
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3070 Issued in AR
Practice address
629 Jack Stephens Dr
Slot 805
Little Rock, AR 72205-5525
Phone
(501) 526-5770
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3070 AR Primary

Addresses

Primary practice location

629 Jack Stephens Dr
Slot 805
Little Rock, AR 72205-5525

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other names 1

  • Amanda Gail Willis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3070ARMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1104259563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 JACK STEPHENS DR",
            "address_2": "SLOT 805",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055525",
            "telephone_number": "501-526-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMANDA",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "3070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILLIS",
            "middle_name": "GAIL",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.