Amanda Wyatt, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018004 Issued in IL

Practice address

1644 E 53Rd St
Chicago, IL 60615-4210

Phone

(773) 214-6450

Fax

(773) 241-6501

NPI assigned

Oct 21, 2010

Last updated

Oct 22, 2010By 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

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Physical Therapy and Rehab Services IncGroup PAC ID 1850370453, 120 clinicians

Practice addresses (Care Compare)

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.

• Northland Physical Therapy & Rehab Services, Inc

  • Physical Therapist
  • N Kansas City, MO
  • NPI 1740273218

  KS

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1427358662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 E 53RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154210",
            "telephone_number": "773-214-6450",
            "fax_number": "773-241-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 E 53RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154210",
            "telephone_number": "773-214-6450",
            "fax_number": "773-241-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "AMANDA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Wurst, LCPC
• Samuel Howard Wurster, MD
• Rebecca Marion Wurtz, MD
• WX Medical Center Corp
• Cameron Wyant, LPC
• Dovilan Wyatt, M.D
• Helen Wyatt
• James Kelley Wyatt, PH.D.
• Joel Daniel Wyatt, MS
• Laura Wyatt

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.