Active NPI
Amy Tantilla
- Physical Therapy Assistant
- Wilmington, NC
National Provider Identifier
1619130853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2570
- Practice address
- 3015 Enterprise Dr
Wilmington, NC 28405-2116 - Phone
- (910) 791-3451
- NPI assigned
- Jul 8, 2008
- 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 Therapy Assistant | 225200000X | 2570 | NC | Primary |
Addresses
Primary practice location
3015 Enterprise Dr
Wilmington, NC 28405-2116
Mailing address
7402 Skycrest CT
Wilmington, NC 28411-7120
Phone (910) 686-8114
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 |
|---|---|---|---|
| 2570 | NC | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1619130853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7402 SKYCREST CT",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284117120",
"telephone_number": "910-686-8114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 ENTERPRISE DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284052116",
"telephone_number": "910-791-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANTILLA",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-08",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "2570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.