Active NPI
Amy Lynn Carroll, PT
- Physical Therapist
- Perrysburg, NY
National Provider Identifier
1255476263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0234051
- Practice address
- 10714 North Rd
Perrysburg, NY 14129-9746 - Phone
- (716) 287-3734
- Fax
- (716) 287-3740
- NPI assigned
- Feb 20, 2007
- 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 | 0234051 | NY | Primary |
Addresses
Primary practice location
10714 North Rd
Perrysburg, NY 14129-9746
Mailing address
31 Beech St
Gowanda, NY 14070-1528
Phone (716) 532-0522
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 |
|---|---|---|---|
| 23405 | NY | MD | General Practice Dentistry |
| 0234051 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-County Physical Therapy, PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Gowanda, NY
- NPI 1083660765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255476263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 BEECH ST",
"city": "GOWANDA",
"state": "NY",
"postal_code": "140701528",
"telephone_number": "716-532-0522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10714 NORTH RD",
"city": "PERRYSBURG",
"state": "NY",
"postal_code": "141299746",
"telephone_number": "716-287-3734",
"fax_number": "716-287-3740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "AMY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0234051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perrysburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.