Amanda Jean Dudek, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-009403 Issued in AZ

Practice address

9385 W Donald Dr
Peoria, AZ 85383-2988

Phone

(602) 875-5616

NPI assigned

Jul 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Shaker Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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 and National Provider Directory roles.

• Sunrise Therapy Services, Inc

  • Rehabilitation Practitioner
  • Phoenix, AZ
  • NPI 1033113501

  Physical Therapist

  Medicare reassignment NPD
• Theracare PLLC

  • Occupational Therapist
  • Peoria, AZ
  • NPI 1962784249

  Physical Therapist

  Medicare reassignment NPD
• Sunrise Therapy Services, Inc

  • Health Service Clinic/Center
  • Phoenix, AZ
  • NPI 1063277689

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1821386376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9328 E OLLA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852121400",
            "telephone_number": "602-736-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9385 W DONALD DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832988",
            "telephone_number": "602-875-5616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 E Shea Blvd",
            "address_2": "Unit 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850286024",
            "country_code": "US",
            "telephone_number": "608-214-5472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "9403PT",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-009403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SHAKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodie Drury
• Katrina Dryer, NP
• DT Dental, PLLC
• Duality Language Services LLC
• Damon Duckworth
• John Matthew Duff, D.C.
• Amber Denise Dugan, FNP-BC
• Jeane Marie Dumbrell, RN IBCLC
• Diana Duncan
• Skylar Anne Dunn, MS, RD

• Physical Therapist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.