Amanda Lukens, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017309 Issued in MI

Practice address

230 Michigan St NE Ste 104
Grand Rapids, MI 49503-2550

Phone

(616) 391-7710

NPI assigned

Mar 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda Witte Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1952804882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MICHIGAN ST NE STE 104",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MICHIGAN ST NE STE 104",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032550",
            "telephone_number": "616-391-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKENS",
        "first_name": "AMANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5501017309",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WITTE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ann Elizabeth Lukacsy, LPC
• Carley Lukas, PT, DPT
• Mackenzie Faith Lukas
• Holly Lukasiewicz, LMSW
• Tricia Maria Vanderbilt Luke, NP
• Jacob Luker, PHARMD
• Cheryl Lukins, M.D.
• Anne Therese Lukshaitis, PT
• Amanda Leigh Lumbert, PA-C
• Mitchell Lumsden, PA-C

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.