Active NPI
Amanda M Uting, DPT
- Physical Therapist
- Wauwatosa, WI
National Provider Identifier
1508294489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 005288
- Practice address
- 530 N 108TH PL Ste 200
Wauwatosa, WI 53226-4253 - Phone
- (414) 708-8066
- NPI assigned
- Oct 31, 2013
- Last updated
- Jul 11, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12491-24 | WI | |
| Physical Therapist | 225100000X | 005288 | IA | Primary |
Addresses
Primary practice location
530 N 108TH PL Ste 200
Wauwatosa, WI 53226-4253
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005288 | Other | IA | IOWA PT LICENSE |
Other names 1
- Amanda M John
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005288 | IA | MD | Physical Therapist |
| 12491-24 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloom Physical Therapy & Wellness | Physical Therapist | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Pewaukee, WI
- NPI 1396515615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1508294489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070",
"fax_number": "309-743-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 N 108TH PL STE 200",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532264253",
"telephone_number": "414-708-8066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTING",
"first_name": "AMANDA",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-31",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12491-24",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "005288",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA PT LICENSE",
"identifier": "005288",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "JOHN",
"middle_name": "M",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wauwatosa, WI
- United Lutheran Program for the Aging, Inc (Luther Manor Hospice)
- United Lutheran Program for the Aging, Inc (The Clinic at Luther Manor)
- United Seating and Mobility LLC (Numotion)
- Unity Bridge Community Services
- University of Wisconsin System Non Payroll
- Matthew T Vahl
- Katrina M Valente, LPC
- Valentin Clinic SC
- Cynthia Celeste-Trout Valentin, PHD APNP
- Nathan A Valentine, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.