Amy Elizabeth Weisse, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

3637 Issued in NC

Practice address

4330 Southport Supply Rd SE Ste 201
Southport, NC 28461-9273

Phone

(901) 457-0113

NPI assigned

Sep 5, 2019

Last updated

Sep 5, 2019By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas Speech Therapy Services PLLC

  • Speech-Language Pathologist
  • Supply, NC
  • NPI 1871860544
  NPD

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1780233494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PIER MASTER PT UNIT 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284125602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 SOUTHPORT SUPPLY RD SE STE 201",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619273",
            "telephone_number": "901-457-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISSE",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "3637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211899",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wallbrown Home Inc.
• Sarah Louise Ward
• Marybeth Weinacht, PT
• James Keller Weingarten, M.D.
• Larry Felix Weisner, MD
• Victoria Wessell, OTR/L
• Jeffrey W Wickline, OTR/L
• Jennifer S. Williams, DDS
• Leonard David Williams IV, D.D.S.
• Wilmington Health PLLC

• Physical Medicine & Rehabilitation Physician in Southport, NC
• Providers in Southport, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.