Individual provider Active NPI

Amanda McCarty Harris, D.P.T.

  • Physical Therapist
  • Pine Bluff, AR
National Provider Identifier
1114242740
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 3181 Issued in AR
Practice address
2801 S Olive St
Suite 9D
Pine Bluff, AR 71603-5433
Phone
(870) 541-0003
Fax
(870) 541-0008
NPI assigned
Apr 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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 PT 3181 AR Primary

Addresses

Primary practice location

2801 S Olive St
Suite 9D
Pine Bluff, AR 71603-5433

Mailing address

2801 S Olive St
Suite 9D
Pine Bluff, AR 71603-5433
Phone (870) 541-0003

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 3181ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Arkansas Physical Therapy, Inc. Physical Therapist PastSince Oct 7, 2002 Accepting new patients

Organizations & group practices 1

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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1114242740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S OLIVE ST",
            "address_2": "SUITE 9D",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035433",
            "telephone_number": "870-541-0003",
            "fax_number": "870-541-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S OLIVE ST",
            "address_2": "SUITE 9D",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035433",
            "telephone_number": "870-541-0003",
            "fax_number": "870-541-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "AMANDA",
        "middle_name": "MCCARTY",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT 3181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.