Individual provider Active NPI

Amanda Godwin, OTD, OTR/L

  • Occupational Therapist
  • Muscatine, IA
National Provider Identifier
1427665264
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056013268 Issued in IL
Practice address
2109 Cedarwood Dr Ste 200
Muscatine, IA 52761-2670
Phone
(563) 263-0557
NPI assigned
Sep 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 098221 IA
Occupational Therapist 225X00000X 056013268 IL Primary

Addresses

Primary practice location

2109 Cedarwood Dr Ste 200
Muscatine, IA 52761-2670

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other practice location 1

4343 Kennedy Dr
East Moline, IL 61244-4203
Phone (309) 796-6600

Other names 1

  • Amanda Berryhill Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831001243 IA Practitioner - Occupational Therapist in Private Practice 9638575673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056013268ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amity Point, LLC Occupational Therapist CurrentSince Feb 19, 2023 Accepting new patients
Rock Valley Physical Therapy Center Occupational Therapist CurrentSince Sep 7, 2021 Accepting new patients
Rock Valley Physical Therapy Center Occupational Therapist CurrentSince Sep 7, 2021 Accepting new patients

Locations

3906 Lillie Ave
Ste 5
Davenport, IA 52806
Phone (563) 223-8404

2109 Cedarwood Dr
Ste 100
Muscatine, IA 52761
Phone (563) 288-6787

2109 Cedarwood Dr
Stop 1
Muscatine, IA 52761
Phone (563) 288-6787

400 Ovesen Dr
Wilton, IA 52778
Phone (563) 732-2121

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

Organizations & group practices 3

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": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1427665264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 CEDARWOOD DR STE 200",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612670",
            "telephone_number": "563-263-0557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4343 Kennedy Dr",
            "address_purpose": "LOCATION",
            "city": "East Moline",
            "state": "IL",
            "postal_code": "612444203",
            "country_code": "US",
            "telephone_number": "309-796-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "AMANDA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "098221",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056013268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BERRYHILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muscatine, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.