Amanda M Brown, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013466 Issued in IL

Practice address

605 N 12TH St
Mount Vernon, IL 62864-2857

Phone

(618) 436-8640

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• King Spinal & Sports Rehabilitation, LTD.

  • Physical Therapist
  • Granite City, IL
  • NPI 1427157593
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1659416923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503927",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500001",
            "telephone_number": "618-436-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642857",
            "telephone_number": "618-436-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "070013466",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley A Braddy, LPN
• Brian J Shaheen MD SC
• Bridge Counseling & Wellness PLLC
• Kelly Brinson, MHP
• Britt the NP
• Bridgett Nicole Brown, FNP-C
• Chelsey Kaye Brown, COTA/L
• Pearl Brown, LCPC
• Kylie Jean Brumley, N/A
• Matthew Bryan

• Physical Therapist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.