Amanda L Blackmon, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 1501 Issued in WY

Practice address

1909 Vista Dr
Laramie, WY 82070-5530

Phone

(307) 721-8024

Fax

(307) 742-3093

NPI assigned

Aug 6, 2013

Last updated

Jul 7, 2015By 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 1

Addresses

Other names 1

• Amanda L Wilkison Former name

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gem City Bone and Joint PCGroup PAC ID 0244144715, 21 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gem City Bone & Joint PC

  • Orthopaedic Surgery Physician
  • Laramie, WY
  • NPI 1366412397

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Gem City Bone & Joint PC

  • Durable Medical Equipment & Medical Supplies
  • Laramie, WY
  • NPI 1952441164
  NPD

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1356773998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 VISTA DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705530",
            "telephone_number": "307-721-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 VISTA DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705530",
            "telephone_number": "307-721-8024",
            "fax_number": "307-742-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT 1501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILKISON",
            "middle_name": "L",
            "credential": "P.T., D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Bishop
• Michael Bishop, PH.D, NCC, LPC
• Emma Marie Bjore, M.D.
• Carly Shay Bjorklund, RBT
• Jeri Black-Farber, PT
• Madeline Blake
• Curt Blakely
• Meranda Blaney
• Jenniffer Blaylock
• Nicole Bleak, PT

• Physical Therapist in Laramie, WY
• Providers in Laramie, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.