Amanda Baltusnik, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1735 Issued in WV

Practice address

41 Baltusrol Dr
Charles Town, WV 25414-3884

Phone

(304) 216-2979

NPI assigned

Aug 17, 2018

Last updated

Jan 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  DC

  Medicare reassignment
• Beyond Limits Mobile Outpatient Therapy, LLC

  • Occupational Therapist
  • Charles Town, WV
  • NPI 1093345894
  Authorized official Same address or phone

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1609356740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BALTUSROL DR",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254143884",
            "telephone_number": "304-216-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BALTUSROL DR",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254143884",
            "telephone_number": "304-216-2979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16505 Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "MD",
            "postal_code": "217951321",
            "country_code": "US",
            "telephone_number": "888-531-2204",
            "fax_number": "855-232-8604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALTUSNIK",
        "first_name": "AMANDA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1735",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006982",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "08464",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "330707",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Charles Town, WV
• Providers in Charles Town, WV by specialty
• Occupational Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.