Amanda Leigh Blake Mitchell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A7951 Issued in NC

Practice address

13801 Oldham PL
Mint Hill, NC 28227-9512

Phone

(704) 701-1781

NPI assigned

Nov 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: amanda.mitchell2@fyzical.com

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1508575010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 OLDHAM PL",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279512",
            "telephone_number": "704-701-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 OLDHAM PL",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279512",
            "telephone_number": "704-701-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AMANDA",
        "middle_name": "LEIGH BLAKE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A7951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "A7951",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Amanda.mitchell2@fyzical.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13801 Oldham Pl",
            "city": "Mint Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282279512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mint Hill Pharmacy LLC
• Mint Hill Primary Care PLLC
• Mint Hill Smiles
• Mint Hill Volunteer Fire Department
• Sophia Raquel Miranda, EDD
• Jennifer Monroe, LMBT
• John Moore
• Kenneth Andrew Morcos, MD
• Zondra Moss, LMFT
• Brandon Curits Mullins

• Physical Therapy Assistant in Mint Hill, NC
• Providers in Mint Hill, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.