Active NPI
Amanda Peterson
- Physical Therapist
- Mountain BRK, AL
National Provider Identifier
1922408129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH7268
- Practice address
- 205 Country Club Park
Mountain BRK, AL 35213-4237 - Phone
- (205) 871-0777
- Fax
- (205) 871-0701
- NPI assigned
- Aug 26, 2014
- 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 | PTH7268 | AL | Primary |
Addresses
Primary practice location
205 Country Club Park
Mountain BRK, AL 35213-4237
Mailing address
2807 Greystone Comm Blvd
Suite 34
Birmingham, AL 35242-9601
Phone (205) 745-3660
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409011200000",
"number": "1922408129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2807 GREYSTONE COMM BLVD",
"address_2": "SUITE 34",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352429601",
"telephone_number": "205-745-3660",
"fax_number": "205-408-4209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 COUNTRY CLUB PARK",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352134237",
"telephone_number": "205-871-0777",
"fax_number": "205-871-0701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-26",
"last_updated": "2014-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH7268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain BRK, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.