Individual provider Active NPI

Amanda Jean Davis, DPT

  • Physical Therapist
  • Southfield, MI
National Provider Identifier
1821397076
Registry record updated Mar 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501015491 Issued in MI
Practice address
29255 Northwestern Hwy
Suite 300
Southfield, MI 48034-1018
Phone
(248) 353-1234
Fax
(248) 353-1211
NPI assigned
Mar 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501015491 MI Primary
Orthopedic Physical Therapist 2251X0800X 5501015491 MI

Addresses

Primary practice location

29255 Northwestern Hwy
Suite 300
Southfield, MI 48034-1018

Mailing address

29255 Northwestern Hwy
Suite 300
Southfield, MI 48034-1018
Phone (248) 353-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000679 MI Practitioner - Physical Therapist in Private Practice 2769650001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ompt Specialists IncGroup PAC ID 7012920416, 32 clinicians

Practice addresses (Care Compare)

4600 Investment Dr
Suite 190
Troy, MI 48098-6365
Phone (248) 353-1234

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
67.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501015491MIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Auto & Work Comp Rehab LLC PastSince Mar 16, 2011 Accepting new patients

Organizations & group practices 2

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": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301097600000",
    "number": "1821397076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY",
            "address_2": "SUITE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341018",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29255 NORTHWESTERN HWY",
            "address_2": "SUITE 300",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341018",
            "telephone_number": "248-353-1234",
            "fax_number": "248-353-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2011-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015491",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501015491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.