Individual provider Active NPI

Amy Lyyski, MPT

  • Physical Therapist
  • Fort Irwin, CA
National Provider Identifier
1821054206
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007606 Issued in GA
Practice address
166 Fourth St
USA Meddac BLDG
Fort Irwin, CA 92310
Phone
(760) 380-6862
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT007606 GA Primary

Addresses

Primary practice location

166 Fourth St
USA Meddac BLDG
Fort Irwin, CA 92310

Mailing address

5163 Cracker Jack LN
Fort Irwin, CA 92310-2071
Phone (760) 380-6862

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007606GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Millbrook Physical Therapy PC 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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1821054206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5163 CRACKER JACK LN",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923102071",
            "telephone_number": "760-380-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 FOURTH ST",
            "address_2": "USA MEDDAC BLDG",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "760-380-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYYSKI",
        "first_name": "AMY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Irwin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.