Individual provider Active NPI

Amanda E Thome, PT, DPT

  • Physical Therapist
  • Sandpoint, ID
National Provider Identifier
1215237201
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-4757 Issued in ID
Practice address
1301 N Division Ave
Sandpoint, ID 83864-8268
Phone
(208) 265-0610
Fax
(208) 265-9192
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01360700 NJ
Physical Therapist 225100000X 1200983 TX
Physical Therapist 225100000X PT-4757 ID Primary

Addresses

Primary practice location

1301 N Division Ave
Sandpoint, ID 83864-8268

Mailing address

1301 N Division Ave
Sandpoint, ID 83864-8268
Phone (208) 265-0610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160906000211 ID Practitioner - Physical Therapist in Private Practice 4789970526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Columbia University College of Physicians and Surgeons, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1327 Superior St
Suite 101
Sandpoint, ID 83864-1735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-4757IDMDPhysical Therapist
40QA01360700NJMDPhysical Therapist
1200983TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Pain Clinic PLLC CurrentSince Aug 1, 2016 Accepting new patients
Sandpoint Physical Therapy PC Physical Therapist PastSince Feb 28, 2019 Accepting new patients

Locations

1327 W Superior St
Ste 101
Sandpoint, ID 83864
Phone (208) 263-9757

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/73383

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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1215237201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N DIVISION AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838648268",
            "telephone_number": "208-265-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N DIVISION AVE",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838648268",
            "telephone_number": "208-265-0610",
            "fax_number": "208-265-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOME",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01360700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1200983",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-4757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.