Amanda Eccles Gotschall, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0012065 Issued in CO

Practice address

209 Seminole Dr
Boulder, CO 80303-4228

Phone

(408) 307-1199

NPI assigned

Feb 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Amanda Jean Eccles Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Anewu Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Boulder, CO
  • NPI 1619560794
  NPD Authorized official
• Coal Creek Diagnostics, LLC

  • Diagnostic Ultrasound Physician
  • Louisville, CO
  • NPI 1366941171
  NPD (past)

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306185665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SEMINOLE DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SEMINOLE DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034228",
            "telephone_number": "408-307-1199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Boulder Road Suite 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "80027",
            "country_code": "US",
            "telephone_number": "408-307-1199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Boulder Road Suite 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "80027",
            "country_code": "US",
            "telephone_number": "408-307-1199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTSCHALL",
        "first_name": "AMANDA",
        "middle_name": "ECCLES",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0012065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ECCLES",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leslie Gordon, P.T.
• Linda S Gore, PA
• Jordan Gorm
• Alyssa Gosselin, PMHNP
• Alison Gothro
• James Laing Gottlieb, M.D.
• William Jia Gottlieb, MD
• Kari E Gottschling
• Jaylyn S Gough, LLMSW
• Angela Pupo Gould, PH.D.

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.