Individual provider Active NPI

Amethyst Deneal, PT, DPT

  • Physical Therapist
  • Salem, IL
National Provider Identifier
1295512614
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070028003 Issued in IL
Practice address
1201 Ricker Rd
Salem, IL 62881-4263
Phone
(618) 548-3194
NPI assigned
Sep 11, 2023
Last updated
Feb 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070028003 IL Primary
Physical Therapist 225100000X 2305215820 VA
Physical Therapist 225100000X P22182 NC
Physical Therapist 225100000X 008989 KY

Addresses

Primary practice location

1201 Ricker Rd
Salem, IL 62881-4263

Mailing address

545 Womble Rd
Harrisburg, IL 62946-5457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, IL, KY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231215003359 VA Practitioner - Physical Therapist in Private Practice 6406205400 Reassigns benefits to 1 organization
I20240306001008 IL Practitioner - Physical Therapist in Private Practice 6406205400 Reassigns benefits to 2 organizations
I20241120003953 KY Practitioner - Physical Therapist in Private Practice 6406205400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.78
Promoting interoperability
99
Improvement activities
40
Cost
75.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008989KYMDPharmacist
070028003ILMDPhysical Therapist
P22182NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 9, 2025 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Jan 15, 2024 Accepting new patients
Select Physical Therapy Holdings, Inc. Physical Therapist CurrentSince Jan 15, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 27, 2023 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Nov 4, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 27, 2023 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Nov 4, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 9, 2025 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients

Locations

900 E Walnut St
Ste 1
Carbondale, IL 62901
Phone (618) 319-7540

1138 W McCord St
Centralia, IL 62801
Phone (618) 352-1310

1835 Solutions Ctr
Chicago, IL 60677

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

814 Highway 36
Frenchburg, KY 40322
Phone (636) 393-0953

1232 Richmond Rd
Ste A
Irvine, KY 40336
Phone (606) 717-0255

272 Kroger Ctr
Morehead, KY 40351
Phone (606) 393-0304

513 Maysville Rd
Mt Sterling, KY 40353
Phone (859) 878-2890

156 W College Ave
Stanton, KY 40380
Phone (606) 393-6505

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

4125 Ironbound Rd
Ste 100
Williamsburg, VA 23188
Phone (757) 220-8383

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706918400000",
    "number": "1295512614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 WOMBLE RD",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629465457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RICKER RD",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628814263",
            "telephone_number": "618-548-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENEAL",
        "first_name": "AMETHYST",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028003",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215820",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22182",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.