Individual provider Active NPI

Amanda Joy Kaiser Fillmore, OTR/L

  • Occupational Therapist
  • Carlsbad, CA
National Provider Identifier
1588166227
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
18338 Issued in CA
Practice address
6070 Avenida Encinas
Carlsbad, CA 92011-1001
Phone
(760) 444-0102
NPI assigned
Mar 7, 2018
Last updated
Mar 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 18338 CA Primary

Addresses

Primary practice location

6070 Avenida Encinas
Carlsbad, CA 92011-1001

Mailing address

9512 Domer Rd
Santee, CA 92071-2511

Other names 1

  • Amanda Joy Kaiser Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620001927 CA Practitioner - Occupational Therapist in Private Practice 6204181951 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy & Sports Medicine Inc CurrentSince Jun 1, 2018 Accepting new patients
DPT Holdings, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

6070 Avenida Encinas
Carlsbad, CA 92011
Phone (760) 388-6475

6070 Avenida Encinas
Ste 100
Carlsbad, CA 92011
Phone (760) 444-0102

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1588166227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9512 DOMER RD",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920712511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 AVENIDA ENCINAS",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111001",
            "telephone_number": "760-444-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "AMANDA",
        "middle_name": "JOY KAISER",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "18338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KAISER",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.