Individual provider Active NPI

Amanda Elliott, DPT

  • Physical Therapist
  • Golden Valley, MN
National Provider Identifier
1699107722
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9481 Issued in MN
Practice address
6701 Country Club Dr
Golden Valley, MN 55427-4602
Phone
(952) 993-5495
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11713-024 WI
Physical Therapist 225100000X 9481 MN Primary

Addresses

Primary practice location

6701 Country Club Dr
Golden Valley, MN 55427-4602

Mailing address

6150 Quinwood LN N
#5104
Plymouth, MN 55442-1301
Phone (815) 275-7006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131118001239 MN Practitioner - Physical Therapist in Private Practice 7911133129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

295 Phalen Blvd
Saint Paul, MN 55130-2400
Phone (651) 495-6200

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7700

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-8080

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11713-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regions Hospital CurrentSince Apr 1, 2017 Accepting new patients
Regions Hospital CurrentSince Apr 1, 2017 Accepting new patients
Group Health, Inc. CurrentSince Mar 24, 2023 Accepting new patients
Group Health, Inc. CurrentSince Mar 24, 2023 Accepting new patients
Group Health, Inc. Current Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1699107722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 QUINWOOD LN N",
            "address_2": "#5104",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554421301",
            "telephone_number": "815-275-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 COUNTRY CLUB DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274602",
            "telephone_number": "952-993-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11713-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.