Individual provider Active NPI

Mamie Yvonne Perry, PTA

  • Physical Therapy Assistant
  • Amarillo, TX
National Provider Identifier
1568079549
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2036564 Issued in TX
Practice address
3701-A-1 Olsen Blvd
Amarillo, TX 79019-3053
Phone
(806) 467-8181
Fax
(806) 467-8282
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2036564 TX Primary

Addresses

Primary practice location

3701-A-1 Olsen Blvd
Amarillo, TX 79019-3053

Mailing address

3701-A-1 Olsen Blvd
Amarillo, TX 79019-3053
Phone (806) 467-8181

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

LicenseStateTypeSpecialty
2036564TXMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Total Enhancement Therapy Inc. PastSince Sep 27, 2020 Accepting new patients

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1568079549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701-A-1 OLSEN BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "790193053",
            "telephone_number": "806-467-8181",
            "fax_number": "806-467-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701-A-1 OLSEN BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "790193053",
            "telephone_number": "806-467-8181",
            "fax_number": "806-467-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MAMIE",
        "middle_name": "YVONNE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2036564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.