Individual provider Active NPI

Amber Rose White, PTA

  • Physical Therapy Assistant
  • Breese, IL
National Provider Identifier
1801525605
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160004220 Issued in IL
Practice address
14335 Jamestown Rd
Breese, IL 62230-3681
Phone
(618) 526-8730
NPI assigned
Jun 7, 2022
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160004220 IL Primary

Addresses

Primary practice location

14335 Jamestown Rd
Breese, IL 62230-3681

Mailing address

15205 Rod N Gun Road
Breese, IL 62230

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL Clinicient Health Information Exchange (HIE)
Direct Messaging Address Samamber@sbcglobal.net Direct
Direct Messaging Address Awhite@empowerme.com Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
160004220ILMDPhysical Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: awhite@empowerme.com

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1801525605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15205 ROD N GUN ROAD",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "62230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14335 JAMESTOWN RD",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303681",
            "telephone_number": "618-526-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "AMBER",
        "middle_name": "ROSE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160004220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Clinicient",
            "affiliation": "N",
            "endpointDescription": "Documentation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14335 Jamestown Rd",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Samamber@sbcglobal.net",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14335 Jamestown Rd",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Awhite@empowerme.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14335 Jamestown Rd",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Breese, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.