Amber Wirtala

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

118449 Issued in TX

Practice address

2517 Broadway Dr
Trophy Club, TX 76262-5040

Phone

(615) 878-5620

NPI assigned

Oct 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Occupational Therapist in Private Practice

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1437601119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 BROADWAY DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625040",
            "telephone_number": "615-878-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 BROADWAY DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625040",
            "telephone_number": "615-878-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTALA",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "TX",
            "license": "118449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "amberwirtala@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "amberwirtala@yahoo.com",
            "address_1": "2517 Broadway Dr",
            "city": "Trophy Club",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762625040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oluchi Ijeoma Uwajumogu, NP 1051106
• Walgreen Co (Walgreens #06047)
• Natalee Weaver, PHARMD
• William Aaron Weller, DPT
• Alexander Wenner, DDS
• Erin Elena Woolsey
• Kris Word
• David Chae Man Yi, MD
• Aaron Young, DC

• Gerontology Occupational Therapist in Trophy Club, TX
• Providers in Trophy Club, TX by specialty
• Gerontology Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.