Active NPI
Amanda Marie Clark, PT
- Physical Therapist
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7101
- Practice address
- 200 Patewood Dr
Ste C150
Greenville, SC 29615-3593 - Phone
- (864) 545-0904
- NPI assigned
- Aug 7, 2013
- Last updated
- Jan 15, 2019
- 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 | 7101 | SC | Primary |
Addresses
Primary practice location
200 Patewood Dr
Ste C150
Greenville, SC 29615-3593
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222
Other names 1
- Amanda Marie Stinson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of Wisconsin School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Patewood Dr
Suite C150
Greenville, SC 29615-6323
Phone (864) 454-0904
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenville Proaxis Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Greenville Proaxis Therapy LLC | Current | Accepting new patients | |
| Prisma Health University Medical Group | Past | Accepting new patients | |
| Physical Rehabilitation Group | Physical Therapist | Past | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
33205 Collection Ctr Dr
Chicago, IL 60693
103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753
200 Patewood Dr
Ste C150
Greenville, SC 29615
Phone (864) 454-0904
200 Patewood Dr
Ste C250
Greenville, SC 29615
Phone (864) 454-0952
727 SE Main St
Ste 200
Simpsonville, SC 29681
Phone (864) 454-6670
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba ATI Physical Therapy of Greenville
- Physical Therapist
- Greenville, SC
- NPI 1669457859
-
dba ATI Physical Therapy
- Durable Medical Equipment & Medical Supplies
- Greenville, SC
- NPI 1740052000
-
- Physical Therapist
- Columbia, SC
- NPI 1629407606
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1881026235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR",
"address_2": "STE C150",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153593",
"telephone_number": "864-545-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-07",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "7101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "STINSON",
"middle_name": "MARIE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.