Individual provider Active NPI

Amy Diane Richards, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1487630828
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25457 Issued in CA
Practice address
4060 4TH Ave
#105
San Diego, CA 92103-2116
Phone
(619) 299-5246
Fax
(619) 299-5751
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25457 CA Primary

Addresses

Primary practice location

4060 4TH Ave
#105
San Diego, CA 92103-2116

Mailing address

200 Newport Center Dr
#213
Newport Beach, CA 92660-7501
Phone (949) 644-1322

Other names 1

  • Amy Diane Sanchez Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT25457CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1487630828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "#213",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "949-644-1322",
            "fax_number": "949-644-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "#105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-299-5246",
            "fax_number": "619-299-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "AMY",
        "middle_name": "DIANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "SANCHEZ",
            "middle_name": "DIANE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.