Individual provider Active NPI

Amber Dawn Loveless, AAS

  • Physical Therapy Assistant
  • Wynne, AR
National Provider Identifier
1134616998
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA4168 Issued in AR
Practice address
319 Martin Dr W
Wynne, AR 72396-3446
Phone
(870) 362-0279
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA4168 AR Primary

Addresses

Primary practice location

319 Martin Dr W
Wynne, AR 72396-3446

Mailing address

319 Martin Dr W
Wynne, AR 72396-3446
Phone (870) 362-0279

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
Credentials
Associate of Applied Science

State licenses

LicenseStateTypeSpecialty
PTA4168ARMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1134616998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 MARTIN DR W",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963446",
            "telephone_number": "870-362-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 MARTIN DR W",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963446",
            "telephone_number": "870-362-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELESS",
        "first_name": "AMBER",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "AAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.