Amanda Wilkie

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

23005204975 Issued in VA

Practice address

355 Oak Grove Rd
Spartenburg, SC 29301-2537

Phone

(864) 595-4225

Fax

(703) 866-0158

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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.

• Pediatrics Unlimited Inc

  • Speech-Language Pathologist
  • Greenville, SC
  • NPI 1417164146

  Pediatrics

  NPD (past)
• Pediatrics Unlimited Inc

  • Music Therapist
  • Spartanburg, SC
  • NPI 1871614537

  Pediatrics

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2008.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1205955689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 BELMONT RIDGE CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201914399",
            "telephone_number": "703-476-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 OAK GROVE RD",
            "city": "SPARTENBURG",
            "state": "SC",
            "postal_code": "293012537",
            "telephone_number": "864-595-4225",
            "fax_number": "703-866-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIE",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "23005204975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gale Clara Dicostanzo
• Julie Robinson McDermott, MD

• All providers in Spartenburg, SC
• Pediatric Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.