Amanda Sparks

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTH8052 Issued in AL

Practice address

5690 Watermelon Rd Ste 100
Northport, AL 35473-5008

Phone

(205) 759-2211

Fax

(205) 759-2213

NPI assigned

Aug 29, 2018

Last updated

Aug 29, 2018By 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 identifiers 1

Other names 1

• Amanda Rudder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tuscaloosa Rehabilitation and Hand Center, Inc

  • Physical Therapy Clinic/Center
  • Northport, AL
  • NPI 1235171026
  NPD (past)

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1396227120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 WATERMELON RD STE 100",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735008",
            "telephone_number": "205-759-2211",
            "fax_number": "205-759-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 WATERMELON RD STE 100",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735008",
            "telephone_number": "205-759-2211",
            "fax_number": "205-759-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "PTH8052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY ASSISTANT LICENSE",
            "identifier": "PTA8052",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "RUDDER",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Sidney Smith, M.D.
• Lisa Branscome Smith
• Susanne Mills Snider, CRNP
• Krista Kelley Snyder, MS CCC SLP
• Sokol Park Chiropractic, LLC
• Kris D Sparks, MSN, CRNP
• Troy Matthew Speigner, EMT
• Alyssa Joyce Spruill, CRNP
• Ansley Stanton
• Julie T Stapp

• Physical Therapy Assistant in Northport, AL
• Providers in Northport, AL by specialty
• Physical Therapy Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.