Individual provider Active NPI

Amanda Nicole Piper, PT

  • Physical Therapist
  • Tyler, TX
National Provider Identifier
1235607110
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1183460 Issued in TX
Practice address
1814 Roseland Blvd
Tyler, TX 75701-4234
Phone
(903) 594-7400
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1183460 TX Primary

Addresses

Primary practice location

1814 Roseland Blvd
Tyler, TX 75701-4234

Mailing address

1814 Roseland Blvd
Tyler, TX 75701-4234
Phone (903) 594-7400

Other names 1

  • Amanda Nicole Roberts Former name

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

LicenseStateTypeSpecialty
1183460TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1235607110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014234",
            "telephone_number": "903-594-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014234",
            "telephone_number": "903-594-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPER",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1183460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ROBERTS",
            "middle_name": "NICOLE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.