Active NPI
Amy K Tarnowski, PT
- Physical Therapist
- Wake Forest, NC
National Provider Identifier
1710465620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P8496
- Practice address
- The Lodge at Wake Forest
1151 South Main Street
Wake Forest, NC 27587 - Phone
- (919) 939-2483
- NPI assigned
- Aug 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P8496 | NC | Primary |
Addresses
Primary practice location
The Lodge at Wake Forest
1151 South Main Street
Wake Forest, NC 27587
Mailing address
3408 Kennebuck CT
Raleigh, NC 27613-1330
Phone (919) 741-8092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12800 Spruce Tree Way
Raleigh, NC 27614-7077
Phone (919) 554-3106
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P8496 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Physical Therapist | Current | Accepting new patients |
| Legacy Healthcare Services, Inc. | Physical Therapist | Current | Accepting new patients |
Locations
12800 Spruce Tree Way
Raleigh, NC 27614
Phone (919) 554-0711
1151 S Main St
Wake Forest, NC 27587
Phone (919) 554-8768
Organizations & group practices 2
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.
-
- Physical Therapist
- Durham, NC
- NPI 1104823400
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1710465620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3408 KENNEBUCK CT",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276131330",
"telephone_number": "919-741-8092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "THE LODGE AT WAKE FOREST",
"address_2": "1151 SOUTH MAIN STREET",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "27587",
"telephone_number": "919-939-2483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARNOWSKI",
"first_name": "AMY",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-02",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P8496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.