Individual provider Active NPI

Amy Jean Martin, PT

  • Physical Therapist
  • Fort Thomas, KY
National Provider Identifier
1639388895
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003341 Issued in KY
Practice address
48 Gregory LN
Fort Thomas, KY 41075-1030
Phone
(859) 781-5964
Fax
(859) 781-0448
NPI assigned
May 22, 2007
Last updated
Apr 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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 003341 KY Primary

Addresses

Primary practice location

48 Gregory LN
Fort Thomas, KY 41075-1030

Mailing address

7536 US Hwy 42
Suite 2
Florence, KY 41042
Phone (859) 918-5045

Other identifiers 1

IdentifierTypeStateIssuer
7100643760MedicaidKY

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

LicenseStateTypeSpecialty
003341KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Specialists, Inc. CurrentSince Apr 19, 2020 Accepting new patients

Locations

7536 US Highway 42
Florence, KY 41042
Phone (859) 918-5045

7536 US Route 42
Ste 2
Florence, KY 41042
Phone (859) 391-7118

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1639388895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7536 US HWY 42",
            "address_2": "SUITE 2",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-918-5045",
            "fax_number": "859-757-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 GREGORY LN",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751030",
            "telephone_number": "859-781-5964",
            "fax_number": "859-781-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMY",
        "middle_name": "JEAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100643760",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.