Amanda Joelle Uttech

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15599-24 Issued in WI

Practice address

700 Geneva Pkwy
Lake Geneva, WI 53147-4594

Phone

(262) 249-3500

NPI assigned

Sep 8, 2021

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 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Burlington, WI
  • NPI 1881773463
  Medicare reassignment NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • New Berlin, WI
  • NPI 1285205195
  NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Hayward, WI
  • NPI 1902556012
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1699444190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-249-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GENEVA PKWY",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474594",
            "telephone_number": "262-249-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3620 57th Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531444925",
            "country_code": "US",
            "telephone_number": "262-925-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UTTECH",
        "first_name": "AMANDA",
        "middle_name": "JOELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15599-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100222713",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN LICENSE",
            "identifier": "15599-24",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Rae Trunk, OTR/L
• Michele Turcotte
• Megan Uhlenhake, LPC-IT
• Meredith Sue Umnus, PT
• Uniquely You Therapies LLC
• Jake S Vacarella, MD
• John R Van Susteren, PT
• Denise Vavra, P.T.
• Vision & Eye Health Associates
• Ashley L Vos, NP

• Physical Therapist in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.