Individual provider Active NPI

Amanda Grace Hodge, DPT

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1609185727
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11859 Issued in AZ
Practice address
1675 E Melrose St Ste 101-103
Gilbert, AZ 85297-1001
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 37148 CA
Physical Therapist 225100000X 11859 AZ Primary

Addresses

Primary practice location

1675 E Melrose St Ste 101-103
Gilbert, AZ 85297-1001

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129001447 AZ Practitioner - Physical Therapist in Private Practice 5193992253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1675 E Melrose St
Suite 101 103
Gilbert, AZ 85297-1001
Phone (602) 631-3161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37148CAMDChiropractor
11859AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC Physical Therapist CurrentSince Jun 12, 2021 Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince Jun 12, 2021 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Apr 30, 2021 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Apr 30, 2021 Accepting new patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Sports & Orthopedic Leaders Physical Therapy, Inc Physical Therapist PastSince May 17, 2019 Accepting new patients

Locations

525 S Chandler Village Dr
Chandler, AZ 85226
Phone (480) 750-0303

7225 W Harrison St
Chandler, AZ 85226
Phone (480) 306-4160

2940 E Banner Gateway Dr
Ste 200
Gilbert, AZ 85234

1675 E Melrose St
Ste 101103
Gilbert, AZ 85297
Phone (602) 631-3161

1675 E Melrose St
Unit 101
Gilbert, AZ 85297

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

2835 E Brown Rd
Ste 101
Mesa, AZ 85213
Phone (480) 807-6644

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

2355 E Camelback Rd
Ste 325
Phoenix, AZ 85016
Phone (602) 772-3795

40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

Organizations & group practices 6

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1609185727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E MELROSE ST STE 101-103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971001",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "AMANDA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37148",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.