Amanda L Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

007495 Issued in KY

Practice address

516 Garden Way
Edgewood, KY 41017-3387

Phone

(941) 894-2956

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, OH2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Life Home Therapy, LLCGroup PAC ID 0941637219, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Optimal Life Home Therapy, LLC

  • Physical Therapist
  • Edgewood, KY
  • NPI 1285273383
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1891852604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 GARDEN WAY",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173387",
            "telephone_number": "941-894-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 GARDEN WAY",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173387",
            "telephone_number": "941-894-2956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 S Osprey Ave",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393512",
            "country_code": "US",
            "telephone_number": "941-957-3279",
            "fax_number": "941-957-0243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23094",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE",
            "identifier": "AE321Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Nicole Sketch, PA-C
• Jo Slageter
• Harry W Sleet II, DMD, MD
• Adam T Slone, D.O
• Jessica Renae Smallwood, RBT
• Ashley Smith, RBT
• Cassandra Ann Smith, CRNA
• Daniel David Smith, FNP-C
• Derek Nathaniel Smith, DNP
• Emily C Smith, CRNA

• Physical Therapist in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.

Verify at the official NPI Registry.