Active NPI
Amanda Diane Berg, L.M.T.
- Massage Therapist
- Little Rock, AR
National Provider Identifier
1366711004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7376
- Practice address
- 1405 N. Pierce St.
Suite 210
Little Rock, AR 72207 - Phone
- (501) 664-6664
- Fax
- (501) 664-6614
- NPI assigned
- Dec 27, 2011
- Last updated
- Dec 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7376 | AR | Primary |
Addresses
Primary practice location
1405 N. Pierce St.
Suite 210
Little Rock, AR 72207
Mailing address
1405 N. Pierce St.
Suite 210
Little Rock, AR 72207
Phone (501) 664-6664
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7376 | AR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lori Lamitina, D.C., P.a. | Past | Accepting new patients |
Organizations & group practices 1
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": "1324944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324944000000",
"number": "1366711004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 N. PIERCE ST.",
"address_2": "SUITE 210",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72207",
"telephone_number": "501-664-6664",
"fax_number": "501-664-6614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 N. PIERCE ST.",
"address_2": "SUITE 210",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72207",
"telephone_number": "501-664-6664",
"fax_number": "501-664-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "AMANDA",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-27",
"last_updated": "2011-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AR",
"license": "7376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.