Active NPI
Amanda Elizabeth Whitaker, PT
- Physical Therapist
- Kokomo, IN
National Provider Identifier
1720217227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05009920A
- Practice address
- 1220 Laguna St
Kokomo, IN 46902-2330 - Phone
- (765) 454-5340
- Fax
- (765) 454-5347
- NPI assigned
- Jul 7, 2009
- 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 | 05009920A | IN | Primary |
Addresses
Primary practice location
1220 Laguna St
Kokomo, IN 46902-2330
Mailing address
1220 Laguna St
Kokomo, IN 46902-2330
Phone (765) 454-5340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05009920A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidworks, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1246924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246924800000",
"number": "1720217227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 LAGUNA ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469022330",
"telephone_number": "765-454-5340",
"fax_number": "765-454-5347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 LAGUNA ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469022330",
"telephone_number": "765-454-5340",
"fax_number": "765-454-5347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "AMANDA",
"middle_name": "ELIZABETH",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-07",
"last_updated": "2009-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05009920A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.