Active NPI
Amruta Pradhan
- Physical Therapist
- Springfield, IL
National Provider Identifier
1235579673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070019143
- Practice address
- 3400 W Washington St
Springfield, IL 62711-7917 - Phone
- (217) 787-9600
- NPI assigned
- Jun 30, 2013
- 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 Therapist | 225100000X | 070019143 | IL | Primary |
Addresses
Primary practice location
3400 W Washington St
Springfield, IL 62711-7917
Mailing address
2215A S Koke Mill Rd
Springfield, IL 62711-9633
Phone (309) 533-2130
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070019143 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372550400000",
"number": "1235579673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215A S KOKE MILL RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627119633",
"telephone_number": "309-533-2130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 W WASHINGTON ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627117917",
"telephone_number": "217-787-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADHAN",
"first_name": "AMRUTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-30",
"last_updated": "2013-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070019143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.