Active NPI
Amanda K Wilson, PT
- Physical Therapist
- Hermantown, MN
National Provider Identifier
1366647919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7917
- Practice address
- 4195 Westberg Rd
Hermantown, MN 55811-2962 - Phone
- (218) 216-9921
- NPI assigned
- Jun 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7917 | MN | Primary |
Addresses
Primary practice location
4195 Westberg Rd
Hermantown, MN 55811-2962
Mailing address
PO Box 13238
Grand Forks, ND 58208-3238
Phone (888) 807-5422
Other names 1
- Amanda K Carlson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1813 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1366647919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13238",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582083238",
"telephone_number": "888-807-5422",
"fax_number": "208-561-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4195 WESTBERG RD",
"city": "HERMANTOWN",
"state": "MN",
"postal_code": "558112962",
"telephone_number": "218-216-9921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "AMANDA",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "7917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "CARLSON",
"middle_name": "K",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hermantown, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.