Amanda Zimmerman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

007915 Issued in KY

Practice address

529 Westport Rd
Elizabethtown, KY 42701-2923

Phone

(502) 633-1007

NPI assigned

Jun 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Logsdon Former name

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": "1622851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1588231971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 RIDGE POINT DR",
            "city": "BRANDENBURG",
            "state": "KY",
            "postal_code": "401089647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 WESTPORT RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012923",
            "telephone_number": "502-633-1007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82 Ridge Point Dr",
            "address_purpose": "LOCATION",
            "city": "Brandenburg",
            "state": "KY",
            "postal_code": "401089647",
            "country_code": "US",
            "telephone_number": "270-945-9085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "AMANDA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-05",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LOGSDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.

Verify at the official NPI Registry.