Active NPI
Amanda Blackmon, D.P.T.
- Physical Therapist
- Atlanta, GA
National Provider Identifier
1831268176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT008401
- Practice address
- 3300 Northeast Expy NE
Building 8, Suite C
Atlanta, GA 30341-3932 - Phone
- (770) 500-3848
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT008401 | GA | Primary |
Addresses
Primary practice location
3300 Northeast Expy NE
Building 8, Suite C
Atlanta, GA 30341-3932
Mailing address
3300 Northeast Expy NE
Building 8, Suite C
Atlanta, GA 30341-3932
Phone (770) 500-3848
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT008401 | Other | GA | STATE LISC NUMBER |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One on One Physical Therapy | Past | Accepting new patients | |
| Westside Physical Therapy, LLC | Physical Therapist | Past | 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.
-
- Physical Therapy Clinic/Center
- Atlanta, GA
- NPI 1962868620
-
- Orthopedic Physical Therapist
- Atlanta, GA
- NPI 1669862769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248825600000",
"number": "1831268176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 NORTHEAST EXPY NE",
"address_2": "BUILDING 8, SUITE C",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303413932",
"telephone_number": "770-500-3848",
"fax_number": "678-868-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 NORTHEAST EXPY NE",
"address_2": "BUILDING 8, SUITE C",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303413932",
"telephone_number": "770-500-3848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMON",
"first_name": "AMANDA",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2009-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT008401",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LISC NUMBER",
"identifier": "PT008401",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.