Amanda Elizabeth Tyson Broadwater

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT003732 Issued in GA

Practice address

3500 Lenox Rd NE Ste 1500
Atlanta, GA 30326-4231

Phone

(877) 407-3422

NPI assigned

Sep 29, 2021

Last updated

Mar 22, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902
  NPD
• Au Medical Center, Inc.

  dba AU Medical Center Employee Pharmacy

  • Community/Retail Pharmacy
  • Augusta, GA
  • NPI 1487901476
  NPD
• Fox Rehabilitation Ga, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1023544624
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  NPD

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1538831599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 LENOX RD NE STE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303264231",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON BROADWATER",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT003732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela C. Tyre, PT
• Lynn Helen Tyree, LCSW
• Megan Tyree, APRN,FNP-C
• Anjelica Tyrell, DDS
• Robert T Tyrrel, MD
• Liana Tyson-Haynes, PHARM.D.
• Marion Bianca Tyson, DPT
• Suntavia U Tyson
• Sydney Tzou
• U.S. Healthworks Medical Group of Georgia, Inc.

• Physical Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.