Individual provider Active NPI

Amy M Greenfield, PT

  • Physical Therapist
  • Spooner, WI
National Provider Identifier
1104853720
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9895-024 Issued in WI
Practice address
112 Ash St
Spooner, WI 54801-1487
Phone
(715) 635-3979
Fax
(715) 635-3990
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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 9895-024 WI Primary

Addresses

Primary practice location

112 Ash St
Spooner, WI 54801-1487

Mailing address

112 Ash St
Spooner, WI 54801-1487
Phone (715) 635-3979

Other names 1

  • Amy M Sundeen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060419000183 WI Practitioner - Physical Therapist in Private Practice 4688683600 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Physical Therapy & Sports Rehab, LLC CurrentSince Mar 23, 2022 Accepting new patients
Greenfield PT Comp LLC Physical Therapist Current Accepting new patients
Advantage PT & Sports Rehab LLC CurrentSince Mar 23, 2022 Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC Current Accepting new patients
Spooner Physical Therapy & Wellness Inc Physical Therapist PastSince Oct 16, 2017 Accepting new patients

Locations

204 S Pine St
Burlington, WI 53105
Phone (262) 767-9579

10405 Vermont Ave
Hayward, WI 54843
Phone (715) 699-1355

600 52nd St
Ste 240
Kenosha, WI 53140
Phone (262) 656-0006

3921 30th Ave
Ste C
Kenosha, WI 53144
Phone (262) 925-5000

112 Ash St
Spooner, WI 54801
Phone (715) 635-2518

112 Ash St
Ste A
Spooner, WI 54801
Phone (715) 635-3979

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1104853720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ASH ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011487",
            "telephone_number": "715-635-3979",
            "fax_number": "262-925-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ASH ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011487",
            "telephone_number": "715-635-3979",
            "fax_number": "715-635-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "9895-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "SUNDEEN",
            "middle_name": "M",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spooner, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.