Active NPI
Amy Gose, PTA
- Physical Therapy Assistant
- Elkhart, IN
National Provider Identifier
1871017897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0600420A
- Practice address
- 3109 E Bristol St
Elkhart, IN 46514-4372 - Phone
- (574) 330-4004
- NPI assigned
- Aug 1, 2017
- Last updated
- Aug 1, 2017
- 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 Therapy Assistant | 225200000X | 0600420A | IN | Primary |
Addresses
Primary practice location
3109 E Bristol St
Elkhart, IN 46514-4372
Mailing address
60680 Wood Lake Rd
Three Rivers, MI 49093-9216
Phone (269) 718-4503
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0600420A | IN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501545600000",
"number": "1871017897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60680 WOOD LAKE RD",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490939216",
"telephone_number": "269-718-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3109 E BRISTOL ST",
"city": "ELKHART",
"state": "IN",
"postal_code": "465144372",
"telephone_number": "574-330-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSE",
"first_name": "AMY",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-01",
"last_updated": "2017-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "0600420A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.