Amanda B Dorner, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA27513 Issued in FL

Practice address

521 E Cedar Ave Ste a
Crestview, FL 32539-2860

Phone

(850) 331-3017

Fax

(850) 331-6635

NPI assigned

Nov 15, 2012

Last updated

Jan 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda B Carlile Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carlsbad Physical Therapy & Wellness Center, LLC

  • Physical Therapist
  • Carlsbad, NM
  • NPI 1841205200
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1255675229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E CEDAR AVE STE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325392860",
            "telephone_number": "850-331-3017",
            "fax_number": "850-331-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E CEDAR AVE STE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325392860",
            "telephone_number": "850-331-3017",
            "fax_number": "850-331-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNER",
        "first_name": "AMANDA",
        "middle_name": "B",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-0913",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA27513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CARLILE",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrice Dixon, MSW, RCSWI
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• Brianna Marie Doehrmann, RBT
• Steven Scott Donchey, MD
• Emma Doran
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• Rebecca Jean Drake, MSN, FNP
• Dress Gynecology & Associates PA
• Alison Drummer

• Physical Therapy Assistant in Crestview, FL
• Providers in Crestview, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.