Amanda E Henrichs, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070024687 Issued in IL

Practice address

1915 Carlyle Ave Ste D
Belleville, IL 62221-4578

Phone

(618) 310-0305

NPI assigned

Dec 13, 2017

Last updated

Mar 9, 2021By 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 2

Addresses

Other names 1

• Amanda E Peters Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: amanda.peters.p2@direct.athleticoltd.nextgenshare.com

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1679088520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 CARLYLE AVE STE D",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622214578",
            "telephone_number": "618-310-0305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "MO",
            "postal_code": "630251223",
            "country_code": "US",
            "telephone_number": "636-549-0151",
            "fax_number": "636-549-0152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRICHS",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "PETERS",
            "middle_name": "E",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Khamryn Jeanette Hendricks
• Larry Anthony Henken, RPH
• Nicole Henson
• Torey Hentis
• Christopher M. Herndon, PHARMD, BCPS
• Lola Herndon
• Nolan Paul Herrell, PA

• Physical Therapist in Belleville, IL
• Providers in Belleville, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.