Individual provider Active NPI

Amanda Kristin McCune, DPT, PT

  • Physical Therapist
  • Bel Air, MD
National Provider Identifier
1508720012
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30713 Issued in MD
Practice address
1131 Baltimore Pike Ste 201
Bel Air, MD 21014-5132
Phone
(410) 838-6070
NPI assigned
Dec 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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 30713 MD Primary

Addresses

Primary practice location

1131 Baltimore Pike Ste 201
Bel Air, MD 21014-5132

Mailing address

807 S Union Ave # a
Havre de Grace, MD 21078-3610
Phone (410) 939-2262

Other practice location 1

807 S Union Ave # A
Havre DE Grace, MD 21078-3610
Phone (410) 939-2262

Other names 1

  • Amanda Kristin Wagner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260127004358 MD Practitioner - Physical Therapist in Private Practice 0840778395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smith and Prothero Physical Therapy LLCGroup PAC ID 9335155860, 9 clinicians

Practice addresses (Care Compare)

807 A S Union Ave
Havre de Grace, MD 21078-3610
Phone (410) 939-2262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30713MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Smith & Prothero Physical Therapy LLC Physical Therapist CurrentSince Jan 5, 2026 Accepting new patients
Smith & Prothero Physical Therapy LLC CurrentSince Dec 14, 2025 Accepting new patients

Locations

807 S Union Ave
#A
Havre de Grace, MD 21078
Phone (410) 939-2262

807A S Union Ave
Hvre de Grace, MD 21078
Phone (410) 939-2262

Organizations & group practices 2

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": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1508720012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S UNION AVE # A",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783610",
            "telephone_number": "410-939-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BALTIMORE PIKE STE 201",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210145132",
            "telephone_number": "410-838-6070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 S Union Ave # A",
            "address_purpose": "LOCATION",
            "city": "Havre DE Grace",
            "state": "MD",
            "postal_code": "210783610",
            "country_code": "US",
            "telephone_number": "410-939-2262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCUNE",
        "first_name": "AMANDA",
        "middle_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WAGNER",
            "middle_name": "KRISTIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.