Individual provider Active NPI

Amanda Joy Wiederholt, D.P.T

  • Physical Therapist
  • Merriam, KS
National Provider Identifier
1366760787
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10000 W 75TH St
Suite 250
Merriam, KS 66204-2209
Phone
(913) 894-1910
Fax
(913) 894-1174
NPI assigned
May 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

10000 W 75TH St
Suite 250
Merriam, KS 66204-2209

Mailing address

8006 N Thomas Meyers Dr
Apt B
Kansas City, MO 64118-7844

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

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1366760787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8006 N THOMAS MEYERS DR",
            "address_2": "APT B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641187844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST",
            "address_2": "SUITE 250",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662042209",
            "telephone_number": "913-894-1910",
            "fax_number": "913-894-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDERHOLT",
        "first_name": "AMANDA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merriam, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.