Individual provider Active NPI

Amanda Butler, OTD, OTR/L

  • Occupational Therapist
  • Peoria, AZ
National Provider Identifier
1821609751
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-008910 Issued in AZ
Practice address
20470 N Lake Pleasant Rd Ste 107
Peoria, AZ 85382-9708
Phone
(623) 248-3324
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTH-008910 AZ
Occupational Therapist 225X00000X OTH-008910 AZ Primary

Addresses

Primary practice location

20470 N Lake Pleasant Rd Ste 107
Peoria, AZ 85382-9708

Mailing address

15116 N Cotton LN
Surprise, AZ 85388-9618
Phone (623) 248-3324

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
OTH-008910AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
T.E.a.M. 4 Kids, LLC Pediatrics CurrentSince Jul 21, 2024 Accepting new patients

Locations

20470 N Lake Pleasant Rd
Ste 107
Peoria, AZ 85382
Phone (623) 248-3324

15116 N Cotton Ln
Surprise, AZ 85388
Phone (623) 322-8250

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1821609751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15116 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889618",
            "telephone_number": "623-248-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20470 N LAKE PLEASANT RD STE 107",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829708",
            "telephone_number": "623-248-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "AMANDA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "OTH-008910",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-008910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.