Individual provider Active NPI

Amanda Mungenast, PT, DPT

  • Physical Therapist
  • Festus, MO
National Provider Identifier
1144974114
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022004157 Issued in MO
Practice address
1330 YMCA Dr
Festus, MO 63028-2661
Phone
(636) 931-7600
NPI assigned
Feb 9, 2022
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 2022004157 MO Primary

Addresses

Primary practice location

1330 YMCA Dr
Festus, MO 63028-2661

Mailing address

1330 YMCA Dr
Festus, MO 63028-2661

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
2022004157MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St. Louis, LLC PastSince Feb 13, 2022 Accepting new patients
SSM Select Rehab St Louis LLC PastSince Feb 13, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1144974114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 YMCA DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 YMCA DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282661",
            "telephone_number": "636-931-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNGENAST",
        "first_name": "AMANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022004157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.