Individual provider Active NPI

Amanda Welker, LPTA

  • Physical Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1881020204
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06004735A Issued in IN
Practice address
1717 Maplecrest Rd
Fort Wayne, IN 46815-7656
Phone
(855) 202-2089
NPI assigned
Sep 17, 2013
Last updated
Sep 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06004735A IN Primary
Physical Therapy Assistant 225200000X PTA.09127 OH

Addresses

Primary practice location

1717 Maplecrest Rd
Fort Wayne, IN 46815-7656

Mailing address

5247 US Route 224
Convoy, OH 45832-8923
Phone (419) 203-0403

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
06004735AINMDPhysical Therapy Assistant
PTA.09127OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1881020204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 US ROUTE 224",
            "city": "CONVOY",
            "state": "OH",
            "postal_code": "458328923",
            "telephone_number": "419-203-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157656",
            "telephone_number": "855-202-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELKER",
        "first_name": "AMANDA",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06004735A",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA.09127",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.