Active NPI
Amanda Chyrlesa Hudson, PTA
- Physical Medicine & Rehabilitation Physician
- Melbourne, FL
National Provider Identifier
1558020800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 25984
- Practice address
- 6845 Murrell Rd
Melbourne, FL 32940-6872 - Phone
- (321) 253-6321
- NPI assigned
- Dec 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 25984 | FL | Primary |
Addresses
Primary practice location
6845 Murrell Rd
Melbourne, FL 32940-6872
Mailing address
4640 Zoltan Dr
Titusville, FL 32780-6056
Phone (407) 538-0259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25984 | FL | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1558020800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4640 ZOLTAN DR",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327806056",
"telephone_number": "407-538-0259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6845 MURRELL RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329406872",
"telephone_number": "321-253-6321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "AMANDA",
"middle_name": "CHYRLESA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-14",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "FL",
"license": "25984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.