Amanda Nicole Mettlach, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2015002441 Issued in MO

Practice address

731 Hastings St
Mount Vernon, MO 65712-1077

Phone

(417) 366-4654

NPI assigned

Jul 21, 2023

Last updated

Jul 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Locations

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.

• Weldy Family Chiropractic LLC

  dba Mt. Vernon Spine

  • Chiropractor
  • Mount Vernon, MO
  • NPI 1699367466
  NPD
• Surfside Chiropractic Inc.

  dba Surfside Chiropractic

  • Chiropractor
  • Mount Vernon, MO
  • NPI 1952461170
  NPD (past)

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1679253884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 HASTINGS ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121077",
            "telephone_number": "417-366-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 HASTINGS ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121077",
            "telephone_number": "417-366-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTLACH",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MO",
            "license": "2015002441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Lewis McKay, DO
• Amy Melzer, DPT
• Mercy Hospital Springfield (Mercy Emergency Medical Services-Mt. Vernon)
• Amy Lynn Meriweather, PH.D.
• Gavin Bradley Messer, D.D.S.
• Rachael Meusborn
• Jeanette Meyer-Wilson, MSW, LCSW
• Donna L Meyer, D.C.
• Mid - America Hearing Center, Inc
• Andrew Minardi

• Massage Therapist in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Massage Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.