Amanda R Davitt, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 2271 Issued in AR

Practice address

1801 Forest Hills Blvd
205
Bella Vista, AR 72715-3016

Phone

(479) 855-9348

Fax

(479) 855-9358

NPI assigned

May 7, 2013

Last updated

May 7, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mountaincrest Rehab of Bella Vista, Inc.

  • Physical Therapist
  • Bella Vista, AR
  • NPI 1932165982
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1669817342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD",
            "address_2": "205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153016",
            "telephone_number": "479-855-9348",
            "fax_number": "479-855-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD",
            "address_2": "205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153016",
            "telephone_number": "479-855-9348",
            "fax_number": "479-855-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVITT",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA 2271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Pharmacy of Bella Vista LLC
• Travis Crowe, PTA
• Noble Skidmore Dallison, D.D.S
• Hannah Kathryn Daniel
• Jason Wade Davis, LCSW
• Kailyn Dearing
• Anthony David Delcorral, DDS
• Molly Jean Dillon, AU.D.
• Jan Dorsey
• Douglas a Carmical DDS PA

• Physical Therapy Assistant in Bella Vista, AR
• Providers in Bella Vista, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.