Healthcare Provider Details

I. General information

NPI: 1730040015
Provider Name (Legal Business Name): AMY B SHERBY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY B PENEGAR PT

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 SILVER RAIN RD
LAWRENCE KS
66049-5051
US

IV. Provider business mailing address

1122 SILVER RAIN RD
LAWRENCE KS
66049-5051
US

V. Phone/Fax

Practice location:
  • Phone: 785-766-1010
  • Fax:
Mailing address:
  • Phone: 785-766-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-02153
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: