Individual provider Active NPI

Amanda Davidson Jones, DPT

  • Physical Therapist
  • Painesville, OH
National Provider Identifier
1558624031
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013690 Issued in OH
Practice address
50 Normandy Dr
Painesville, OH 44077-1600
Phone
(440) 639-8800
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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 013690 OH Primary

Addresses

Primary practice location

50 Normandy Dr
Painesville, OH 44077-1600

Mailing address

445 Chickamauga Dr
Ste 101
Dayton, TN 37321-4222
Phone (440) 209-1836

Other identifiers 1

IdentifierTypeStateIssuer
0747777MedicaidOH

Other names 1

  • Amanda Davidson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031001310 TN Practitioner - Physical Therapist in Private Practice 7719209964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sport and SpineGroup PAC ID 9032497938, 2 clinicians

Practice addresses (Care Compare)

455 Chickamauga Dr
Suite 101
Dayton, TN 37321-4286
Phone (423) 428-9156

6204 Hixson Pike
Suite 112
Hixson, TN 37343-5072
Phone (423) 654-3020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013690OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sport & Spine Physical Therapist CurrentSince Jul 12, 2016 Accepting new patients

Locations

455 Chickamauga Dr
Ste 101
Dayton, TN 37321
Phone (423) 428-9156

6204 Hixson Pike
Ste 112
Hixson, TN 37343
Phone (423) 531-3989

Organizations & group practices 1

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1558624031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CHICKAMAUGA DR",
            "address_2": "STE 101",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373214222",
            "telephone_number": "440-209-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORMANDY DR",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440771600",
            "telephone_number": "440-639-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON JONES",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "013690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747777",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DAVIDSON",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.