Individual provider Active NPI

Nisha Patel Amtha

  • Physical Therapist
  • Mobile, AL
National Provider Identifier
1164655866
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH 4145 Issued in AL
Practice address
316C S Sage Ave
Mobile, AL 36606-3616
Phone
(251) 470-7772
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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 PTH 4145 AL Primary

Addresses

Primary practice location

316C S Sage Ave
Mobile, AL 36606-3616

Mailing address

2598 Government Blvd
Mobile, AL 36606-1614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091014000450 AL Practitioner - Physical Therapist in Private Practice 8527104009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

316 C S Sage Ave
Mobile, AL 36606-3616
Phone (251) 470-7772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH 4145ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Azalea City Physical Therapy CurrentSince Oct 8, 2022 Accepting new patients

Locations

316 S Sage Ave
Ste C
Mobile, AL 36606

316 S Sage Ave
#C
Mobile, AL 36606
Phone (251) 470-7772

Organizations & group practices 1

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": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1164655866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2598 GOVERNMENT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366061614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316C S SAGE AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366063616",
            "telephone_number": "251-470-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMTHA",
        "first_name": "NISHA",
        "middle_name": "PATEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH 4145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.