Amanda Erin Burnett, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1224269 Issued in TX

Practice address

305 Mallard LN
Taylor, TX 76574-1208

Phone

(512) 352-4765

NPI assigned

Jun 26, 2013

Last updated

Dec 2, 2021By the provider in NPPES

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

Other names 1

• Amanda Erin Wallace Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1205276946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MALLARD LN",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765741208",
            "telephone_number": "512-352-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "AMANDA",
        "middle_name": "ERIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1224269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awallace9533@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "305 Mallard Ln",
            "city": "Taylor",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765741208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WALLACE",
            "middle_name": "ERIN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Taylor, TX
• Providers in Taylor, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.