Individual provider Active NPI

Amanda Digiovanni, OTR

  • Occupational Therapist
  • Marlton, NJ
National Provider Identifier
1164549259
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00301900 Issued in NJ
Practice address
97 Woodlake Dr
Marlton, NJ 08053-3617
Phone
(856) 745-6411
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Occupational Therapist 225X00000X 46TR00301900 NJ Primary

Addresses

Primary practice location

97 Woodlake Dr
Marlton, NJ 08053-3617

Mailing address

97 Woodlake Dr
Marlton, NJ 08053-3617
Phone (856) 373-1466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100113000367 NJ Practitioner - Occupational Therapist in Private Practice 9638210610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champion Physical Therapy and Performance LLCGroup PAC ID 0244674893, 2 clinicians

Practice addresses (Care Compare)

10 Rams Gate CT
Medford, NJ 08055-9704
Phone (609) 241-6339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Physical Therapy and Performance LLC CurrentSince Apr 1, 2025 Accepting new patients
Jag-One Physical Therapy, LLC Past Accepting new patients
Rehabtree Staffing LLC PastSince May 11, 2025 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1164549259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 WOODLAKE DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533617",
            "telephone_number": "856-373-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 WOODLAKE DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533617",
            "telephone_number": "856-745-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIOVANNI",
        "first_name": "AMANDA",
        "name_prefix": "Miss",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00301900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.