Amanda McCollum, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16100-24 Issued in WI

Practice address

6674 Ronald Reagan Ave
Madison, WI 53704-2395

Phone

(608) 556-6120

NPI assigned

Sep 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• Aspire Therapy and Development Services

  • Speech-Language Pathologist
  • Verona, WI
  • NPI 1932594512
  NPD (past)

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1124741517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 PRAIRIE HEIGHTS DR STE 101",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535932238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6674 RONALD REAGAN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537042395",
            "telephone_number": "608-556-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16100-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Lynn McCloskey, MSW
• Brianna Marie McClurg
• Maggie E McClurg, MSN, APNP, FNP-BC
• Patrick Ryan McClurg, MD
• Marilyn McCluskey, NP
• Caitlin McCollum
• Dawn M McComb, PA-C
• Jeri McCombs, DMD
• Joyce Marie McComish, CICSW
• Kevin McConeghey, BA

• Physical Therapist in Madison, WI
• Providers in Madison, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.