Amy Tisdale, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

006776 Issued in GA

Practice address

536 Grand Slam Dr
Evans, GA 30809-8014

Phone

(706) 854-8434

Fax

(706) 854-8435

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• In Home Pediatric Therapy Inc

  • Pediatric Occupational Therapist
  • Evans, GA
  • NPI 1407983232
  NPD (past)
• Peak Rehabilitation, Fitness and Performance Center

  • Physical Therapy Clinic/Center
  • Augusta, GA
  • NPI 1306083878

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508089749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 BRANSFORD RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093007",
            "telephone_number": "706-364-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098014",
            "telephone_number": "706-854-8434",
            "fax_number": "706-854-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "AMY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "006776",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "006776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "006776",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Paul Thompson
• Angelica Thraikill
• Chasity Christina Tierney, FNP-C
• Christopher Joseph Tierney
• Timeless Healthcare LLC
• Kathryn Ricks Toburen, NP-C
• Samantha Shoemaker Tojino, FNP
• Constance Toliver, COTA/L
• Justin Toro
• Andrew William Torrance, MD

• Orthopedic Physical Therapist in Evans, GA
• Providers in Evans, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.