Individual provider Active NPI

Amanda C Reid, PT, DPT

  • Physical Therapist
  • Draper, UT
National Provider Identifier
1619476900
Registry record updated Nov 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1302263 Issued in TX
Practice address
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone
(385) 308-8034
NPI assigned
Feb 1, 2018
Last updated
Nov 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1302263 TX Primary

Addresses

Primary practice location

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096

Mailing address

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone (385) 308-8034

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1302263TXMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: areid422106@direct.sw.org

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669507200000",
    "number": "1619476900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 E WADSWORTH PARK DR STE 230",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208096",
            "telephone_number": "385-308-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 E WADSWORTH PARK DR STE 230",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208096",
            "telephone_number": "385-308-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "AMANDA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2022-11-27",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1302263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2022; 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.