Active NPI
Amanda Lynn Ferg, B.S., PTA
- Physical Therapy Assistant
- Clintonville, WI
National Provider Identifier
1235383803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1220-019
- Practice address
- 70 W Green Tree Rd
Clintonville, WI 54929-1009 - Phone
- (715) 823-2194
- Fax
- (715) 823-1303
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1220-019 | WI | Primary |
Addresses
Primary practice location
70 W Green Tree Rd
Clintonville, WI 54929-1009
Mailing address
70 W Green Tree Rd
Clintonville, WI 54929-1009
Phone (715) 823-2194
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1220-019 | Other | WI | PTA LICENSING NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1220-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1235383803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 W GREEN TREE RD",
"city": "CLINTONVILLE",
"state": "WI",
"postal_code": "549291009",
"telephone_number": "715-823-2194",
"fax_number": "715-823-1303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 W GREEN TREE RD",
"city": "CLINTONVILLE",
"state": "WI",
"postal_code": "549291009",
"telephone_number": "715-823-2194",
"fax_number": "715-823-1303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERG",
"first_name": "AMANDA",
"middle_name": "LYNN",
"credential": "B.S., PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-10",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "1220-019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA LICENSING NUMBER",
"identifier": "1220-019",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clintonville, WI
- John Byron Dewolf III, DMD
- Cynthia Egan, MD
- Kim Marie Erdmann, MD
- Erickson Home Medical Equipment LLC
- Erickson Pharmacy LLC
- Fetter Chiropractic SC
- Abbie Laine Fetter, DC
- Five Star Quality Care
- Five Star Quality Care Wi LLC (Greentree Health and Rehabilitation Center)
- Five Star Quality Care Wi LLC (Pine Manor Health Care Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.