NPIMap

Individual provider Active NPI

Amanda Kaye Pueppke, DPT

  • Physical Therapist
  • Papillion, NE
National Provider Identifier
1891007563
Registry record updated May 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2897 Issued in NE
Practice address
10601 S 72ND St
Ste. 103
Papillion, NE 68046-3407
Phone
(402) 932-2782
Fax
(402) 932-2705
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2897 NE Primary
Physical Therapist 225100000X 004635 IA

Addresses

Primary practice location

10601 S 72ND St
Ste. 103
Papillion, NE 68046-3407

Mailing address

10601 S 72ND St
Ste. 103
Papillion, NE 68046-3407
Phone (402) 932-2782

Other identifiers 1

IdentifierTypeStateIssuer
10025611200MedicaidNE

Other names 1

  • Amanda Treinen Former name

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

LicenseStateTypeSpecialty
2897NEMDMental Health Counselor
004635IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Center Past Accepting new patients
Excel Rehabilitation Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432944000000",
    "number": "1891007563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 S 72ND ST",
            "address_2": "STE. 103",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463407",
            "telephone_number": "402-932-2782",
            "fax_number": "402-932-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 S 72ND ST",
            "address_2": "STE. 103",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463407",
            "telephone_number": "402-932-2782",
            "fax_number": "402-932-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUEPPKE",
        "first_name": "AMANDA",
        "middle_name": "KAYE",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2015-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2897",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004635",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025611200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "TREINEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2015; 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.