Active NPI
Amanda Ellen Crouch, PT, DPT
- Physical Therapist
- Wartburg, TN
National Provider Identifier
1124685912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7311
- Practice address
- 136 Flat Fork Rd
Wartburg, TN 37887-3200 - Phone
- (423) 622-1551
- Fax
- (877) 856-7133
- NPI assigned
- May 28, 2019
- Last updated
- May 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7311 | TN | Primary |
Addresses
Primary practice location
136 Flat Fork Rd
Wartburg, TN 37887-3200
Mailing address
PO Box 8114
Chattanooga, TN 37414-0114
Phone (423) 622-1551
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7311 | Other | TN | HEALTH LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7311 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stellartherapy Services, LLC | Physical Therapist | Current | Accepting new patients |
| Stellar Medical Services, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559001600000",
"number": "1124685912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8114",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374140114",
"telephone_number": "423-622-1551",
"fax_number": "877-856-7133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 FLAT FORK RD",
"city": "WARTBURG",
"state": "TN",
"postal_code": "378873200",
"telephone_number": "423-622-1551",
"fax_number": "877-856-7133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROUCH",
"first_name": "AMANDA",
"middle_name": "ELLEN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2019-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "7311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH LICENSE",
"identifier": "7311",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wartburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.