Amy Carroll, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160005984 Issued in IL

Practice address

N2950 State Road 67
Lake Geneva, WI 53147-2655

Phone

(262) 245-0535

NPI assigned

Aug 24, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1306126115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031277",
            "telephone_number": "815-877-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "AMY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1820-19",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160005984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel R Caminiti, LPC
• Samuel Harrison Cannon Jr., CRNA
• Caregiver Associates, LLC
• Kali R Carlson, MOT, OTR/L
• Beulah Suzanne Carpenter, LMT
• Brook Cash, RN
• Kerry A. Cates, PT
• Paul Michael Cesarz, R.PH.
• Amy Jo Ceshker
• James Chapman, P.T.

• Physical Therapy Assistant in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.