Amber Dyan Barham, PTA
Individual provider Active NPI Physical Therapy Assistant · Blue Springs, MO
NPI 1457740243 · NPPES record last updated Feb 8, 2017
Key facts
- NPI
- 1457740243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2016013016 (MO)
- Practice address
- 505 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5487 - Phone
- (816) 988-2800
- NPI assigned
- Jan 15, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016013016 | MO | MD | Physical Therapy Assistant |
| 66 009768 | NY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 66 009768 | NY | |
| Physical Therapy Assistant | 225200000X | 2016013016 | MO | Yes |
Addresses
Primary practice location
505 NE Adams Dairy Pkwy
Blue Springs, MO 64014-5487
Mailing address
841 NE Independence CT
Lees Summit, MO 64063-2567
Phone (816) 642-4394
Other names
- Ms. Amber Dyan Blodgette
Other providers in Blue Springs, MO
- Balanced Spine and Rehabilitaion Chiropractic Center
- Nina Baleta
- Richard Clemente Bambenek
- Damalye Nateisha Barclay-Debi
- Ann Barela
- Haleigh Barker
- Jessica Melayne Barr
- Megan S Barthman
- Dana Bauer
- Beth Baustian
All providers in Blue Springs, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.