Individual provider Active NPI

Amanda Lindsey Vanvolkinburg, DPT

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1891067419
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030572-1 Issued in NY
Practice address
813 Fay Rd
Syracuse, NY 13219-3009
Phone
(315) 703-0688
NPI assigned
Jan 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 030572-1 NY Primary

Addresses

Primary practice location

813 Fay Rd
Syracuse, NY 13219-3009

Mailing address

274 Tompkins St
Cortland, NY 13045-3009
Phone (607) 756-9886

Other names 1

  • Amanda Lindsey Davies 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
030572-1NYMDPhysical Therapist
030572NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1891067419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 TOMPKINS ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130453009",
            "telephone_number": "607-756-9886",
            "fax_number": "607-756-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 FAY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193009",
            "telephone_number": "315-703-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVOLKINBURG",
        "first_name": "AMANDA",
        "middle_name": "LINDSEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030572-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DAVIES",
            "middle_name": "LINDSEY",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.