Amanda L Peters, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017552 Issued in PA

Practice address

75 Evelyn Dr
Millersburg, PA 17061-1258

Phone

(717) 692-4708

Fax

(717) 692-5464

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amanda Gallas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1720021876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 EVELYN DR",
            "city": "MILLERSBURG",
            "state": "PA",
            "postal_code": "170611258",
            "telephone_number": "717-692-4708",
            "fax_number": "717-692-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "DAPT001605",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014216270001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "GALLAS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beth A Parrish, ATC
• Fennil Patel
• Donna Peers, MOTR/L
• Pennsylvania CVS Pharmacy, L.L.C.
• Stacey L Penvose, ATC
• Erika L Peterson, DPT
• Pinnacle Health Medical Services
• Pinnacle Health Medical Services
• Pinnacle Health Medical Services
• Russell Poole, PT

• All providers in Millersburg, PA
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.