Amanda Gustin, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011553 Issued in GA

Practice address

3005 Old Alabama Rd
Building E Suite 10
Johns Creek, GA 30022-8594

Phone

(770) 552-8852

NPI assigned

Aug 4, 2014

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

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Mercer University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Body-N-Balance

  • Physical Therapist
  • Johns Creek, GA
  • NPI 1295157931
  NPD (past)

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1144639238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 PACES FERRY RD SE",
            "address_2": "STE 478",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395790",
            "telephone_number": "404-479-1739",
            "fax_number": "404-479-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 OLD ALABAMA RD",
            "address_2": "BUILDING E SUITE 10",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228594",
            "telephone_number": "770-552-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTIN",
        "first_name": "AMANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.