Amber L Puissant, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11714-24 Issued in WI

Practice address

3263 Eaton Rd
Green Bay, WI 54311-6830

Phone

(920) 433-6700

NPI assigned

May 31, 2011

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 names 1

• Amber L Enderby Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1982998662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116830",
            "telephone_number": "920-433-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "831 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011808",
            "country_code": "US",
            "telephone_number": "920-487-3676",
            "fax_number": "920-487-3084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140B School Creek Trl",
            "address_purpose": "LOCATION",
            "city": "Luxemburg",
            "state": "WI",
            "postal_code": "542171095",
            "country_code": "US",
            "telephone_number": "920-845-1370",
            "fax_number": "920-845-1379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUISSANT",
        "first_name": "AMBER",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11714-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "ENDERBY",
            "middle_name": "L",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.