Amanda Nicole Larue, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3719 Issued in NC

Practice address

5901 Broken Sound Pkwy Ste 500
Boca Raton, FL 33487-2791

Phone

(800) 875-8999

NPI assigned

Aug 10, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Club Staffing

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1568652972
  NPD (past)
• Club Staffing

  • Long Term Care Hospital
  • Fredericksburg, VA
  • NPI 1952509788
  NPD (past)

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1114159100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 25TH ST NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013029",
            "telephone_number": "828-320-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 BROKEN SOUND PKWY STE 500",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872791",
            "telephone_number": "800-875-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3719",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2070555",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Layne Lara, APRN, FNP-BC
• Ronald Laracuente, M.D.
• Jennifer C. Larmann, AU.D.
• Jeanine Larocca, PHARM D
• Sarah Larsen
• William Jude Larzelere, OMD, L.AC.
• Laser & Cosmetic Dental Center of Boca Raton
• Nicole Paige Lashley, PA-C
• Suzanne Laskas, MD
• Luis Angel Lastre Figueredo

• Physical Therapy Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.