Active NPI
Amanda Rae Carroll, PT
- Physical Therapist
- Lewiston, ME
National Provider Identifier
1891810891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT3049
- Practice address
- 102 Campus Ave
Lewiston, ME 04240 - Phone
- (207) 777-4219
- Fax
- (207) 777-8571
- NPI assigned
- Mar 20, 2007
- 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 | PT3049 | ME | Primary |
Addresses
Primary practice location
102 Campus Ave
Lewiston, ME 04240
Mailing address
PO Box 1052
Gray, ME 04039-1052
Phone (207) 333-7710
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 |
|---|---|---|---|
| PT3049 | ME | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Rehab, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891810891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1052",
"city": "GRAY",
"state": "ME",
"postal_code": "040391052",
"telephone_number": "207-333-7710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 CAMPUS AVE",
"city": "LEWISTON",
"state": "ME",
"postal_code": "04240",
"telephone_number": "207-777-4219",
"fax_number": "207-777-8571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "AMANDA",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT3049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.