Andrew Wade Amundson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10639 Issued in MN

Practice address

3305 Central Park Village Dr Ste 130
Eagan, MN 55121-7707

Phone

(651) 406-8868

NPI assigned

Oct 31, 2017

Last updated

Jan 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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.

• Fairview Express Care

  dba Institute for Athletic Medicine

  • Physical Therapy Clinic/Center
  • Minneapolis, MN
  • NPI 1407834302
  NPD (past)

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1295247179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14287 SHORE LN NE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721274",
            "telephone_number": "952-457-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 CENTRAL PARK VILLAGE DR STE 130",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551217707",
            "telephone_number": "651-406-8868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "MD",
            "postal_code": "216192792",
            "country_code": "US",
            "telephone_number": "410-643-3410",
            "fax_number": "410-643-3461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Crain Hwy S Ste 402",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210616437",
            "country_code": "US",
            "telephone_number": "410-590-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "ANDREW",
        "middle_name": "WADE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-31",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "13410",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012500A.",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27399",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• American Current Care of Minnesota PC (Concentra Urgent Care)
• American Home Health Aide LLC
• Amherst H. Wilder Foundation (Housing Support)
• Ayman Amin, NP
• Salma Yasir Amoud
• Lynne Marlene Amundson, REGISTERED NURSE
• Arlow (Bill) William Andersen, PH.D., L.P.
• Amy Eileen Anderson, CNP
• Carley Anderson
• Jeff Bruce Anderson, O.D.

• Physical Therapist in Eagan, MN
• Providers in Eagan, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.