Individual provider Active NPI

Amanda Kay Wyant, D.C.

  • Chiropractor
  • Avon, IN
National Provider Identifier
1003110883
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002557A Issued in IN
Practice address
2279 Gray Birch CT
Avon, IN 46123-8238
Phone
(636) 577-3464
NPI assigned
Jan 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002557A IN Primary

Addresses

Primary practice location

2279 Gray Birch CT
Avon, IN 46123-8238

Mailing address

2279 Gray Birch CT
Avon, IN 46123-8238
Phone (636) 577-3464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110322000854 IN Practitioner - Chiropractic 1052594439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Chiropractic and Wellness LLCGroup PAC ID 1355524737, 6 clinicians

Practice addresses (Care Compare)

3183 N National Rd
Columbus, IN 47201-3164
Phone (812) 373-3376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002557AINMDChiropractor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1003110883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 GRAY BIRCH CT",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238238",
            "telephone_number": "636-577-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 GRAY BIRCH CT",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238238",
            "telephone_number": "636-577-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYANT",
        "first_name": "AMANDA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002557A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.