Amanda Deangelo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10517 Issued in MN

Practice address

6401 Southdale Hospital
LL3G
Edina, MN 55435

Phone

(952) 924-8091

NPI assigned

Apr 9, 2018

Last updated

Apr 9, 2018By the provider in NPPES

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 names 1

• Amanda Roberson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1538666326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 NORTHWOOD DR APT 231",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212066",
            "telephone_number": "860-836-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 SOUTHDALE HOSPITAL",
            "address_2": "LL3G",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-924-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELO",
        "first_name": "AMANDA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ROBERSON",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kate Stacken Dawson, CCC-SLP
• Day & Night Home Care Corp
• Patrick Renz De Guzman
• Ines De Llano, D.D.S.
• Erik De Water, PHD
• Daniel G Debban, CRNA
• Kimberly R Debeer, LICSW
• Amber Degraff
• Scott David Degregorio, M.D.
• Melanie A Dehart, M.D.

• Physical Therapist in Edina, MN
• Providers in Edina, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.