Active NPI
Amy Elizabeth Caudillo, DPT
- Physical Therapist
- Eagle River, AK
National Provider Identifier
1447692017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 9303
- Practice address
- 12812 Old Glenn Hwy Ste 5
Eagle River, AK 99577-7558 - Phone
- (907) 317-9349
- NPI assigned
- Jul 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 9303 | AZ | Primary |
Addresses
Primary practice location
12812 Old Glenn Hwy Ste 5
Eagle River, AK 99577-7558
Mailing address
12812 Old Glenn Hwy Ste 5
Eagle River, AK 99577-7558
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 9303 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Programs for Infants & Children, Inc | Past | Accepting new patients | |
| Kids First Pediatric Therapy | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Occupational Therapist
- Anchorage, AK
- NPI 1649888520
-
- Pediatric Occupational Therapist
- Anchorage, AK
- NPI 1164571238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1447692017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12812 OLD GLENN HWY STE 5",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12812 OLD GLENN HWY STE 5",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777558",
"telephone_number": "907-317-9349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAUDILLO",
"first_name": "AMY",
"middle_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "PT 9303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle River, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.