Individual provider Active NPI

Amy Konieczny, DPT

  • Physical Therapist
  • Maumee, OH
National Provider Identifier
1174929343
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1675 Lance Pointe Rd
Maumee, OH 43537-1603
Phone
(419) 891-9800
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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 OH Primary

Addresses

Primary practice location

1675 Lance Pointe Rd
Maumee, OH 43537-1603

Mailing address

24530 W Moline Martin Rd
Millbury, OH 43447-9528
Phone (419) 349-7122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170126000118 OH Practitioner - Physical Therapist in Private Practice 7517249634 Reassigns benefits to 2 organizations
I20181109001772 CO Practitioner - Physical Therapist in Private Practice 7517249634 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Mesa Spine and Sport, LLC CurrentSince Jun 11, 2018 Accepting new patients
Tail Wind Therapies PC Physical Therapist CurrentSince Sep 27, 2022 Accepting new patients
Sandusky Wellness Center Inc CurrentSince May 1, 2018 Accepting new patients
Brent L. Rubin & Associates Inc CurrentSince Dec 1, 2016 Accepting new patients
Brent L. Rubin & Associates Inc PastSince Aug 11, 2019 Accepting new patients
Kenneth C. Lewis MD,LLC PastSince Jul 3, 2022 Accepting new patients
Sandusky Wellness DME LLC Past Accepting new patients

Locations

201 W Park Dr
Grand Junction, CO 81505
Phone (970) 242-0162

2472 Patterson Rd
Unit 9
Grand Junction, CO 81505
Phone (970) 245-0511

3703 Columbus Ave
Sandusky, OH 44870
Phone (419) 625-8085

3055 W Sylvania Ave
Toledo, OH 43613
Phone (419) 471-1172

7071 W Central Ave
Toledo, OH 43617
Phone 4198431370 ext. 130

Organizations & group practices 8

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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1174929343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24530 W MOLINE MARTIN RD",
            "city": "MILLBURY",
            "state": "OH",
            "postal_code": "434479528",
            "telephone_number": "419-349-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LANCE POINTE RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371603",
            "telephone_number": "419-891-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIECZNY",
        "first_name": "AMY",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.