Amy Marie Whitlatch-Gillum, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

01782 Issued in IA

Practice address

708 S Jefferson Way
Indianola, IA 50125-0319

Phone

(515) 961-2596

Fax

(515) 961-2860

NPI assigned

Jul 24, 2007

Last updated

Jul 24, 2007By 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)

Not enrolled

State licenses

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1548460876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S JEFFERSON WAY",
            "address_2": "PO BOX 319",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501250319",
            "telephone_number": "515-961-2596",
            "fax_number": "515-961-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S JEFFERSON WAY",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501250319",
            "telephone_number": "515-961-2596",
            "fax_number": "515-961-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLATCH-GILLUM",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "01782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Indianola, IA
• Providers in Indianola, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.