Active NPI
Amanda Sisler
- Physical Therapist
- Logan, WV
National Provider Identifier
1720452311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT002680
- Practice address
- 506 Holly Ave
Logan, WV 25601-3306 - Phone
- (304) 282-5206
- NPI assigned
- Nov 19, 2015
- Last updated
- Nov 19, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | PT002680 | WV | Primary |
Addresses
Primary practice location
506 Holly Ave
Logan, WV 25601-3306
Mailing address
PO Box 112
Verdunville, WV 25649-0112
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 |
|---|---|---|---|
| PT002680 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447891200000",
"number": "1720452311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 112",
"city": "VERDUNVILLE",
"state": "WV",
"postal_code": "256490112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 HOLLY AVE",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013306",
"telephone_number": "304-282-5206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISLER",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-19",
"last_updated": "2015-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "PT002680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.