Active NPI
Amanda Blinn, PT, DPT
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1609318666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05012306A
- Practice address
- 4935 Hillegas Rd
Fort Wayne, IN 46818-1934 - Phone
- (260) 338-1241
- NPI assigned
- Nov 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05012306A | IN | Primary |
Addresses
Primary practice location
4935 Hillegas Rd
Fort Wayne, IN 46818-1934
Mailing address
PO Box 80867
Fort Wayne, IN 46898-0867
Phone (260) 338-1241
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05012306A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Possibilities Northeast, LLC. | Physical Therapist | Past | 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.
-
- Speech-Language Pathologist
- Fort Wayne, IN
- NPI 1881734697
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1609318666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80867",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468980867",
"telephone_number": "260-338-1241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4935 HILLEGAS RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468181934",
"telephone_number": "260-338-1241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLINN",
"first_name": "AMANDA",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-08",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05012306A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.