Individual provider Active NPI

Amanda Walker, PT,DPT

  • Physical Therapist
  • Highland HTS, OH
National Provider Identifier
1124844873
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017283 Issued in OH
Practice address
677 Jefferson Dr
Highland HTS, OH 44143-2036
Phone
(440) 665-2430
NPI assigned
Nov 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 PT017283 OH Primary

Addresses

Primary practice location

677 Jefferson Dr
Highland HTS, OH 44143-2036

Mailing address

677 Jefferson Dr
Highland HTS, OH 44143-2036
Phone (440) 665-2430

Other names 1

  • Amanda Videmsek Former name

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
PT017283OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1124844873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 JEFFERSON DR",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441432036",
            "telephone_number": "440-665-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 JEFFERSON DR",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441432036",
            "telephone_number": "440-665-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "AMANDA",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT017283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "VIDEMSEK",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.