Amanda N Fawson, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

2155 Grant Ave
Apt 241
Ogden, UT 84401-1462

Phone

(435) 840-4113

NPI assigned

Mar 25, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1003278300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 GRANT AVE",
            "address_2": "APT 241",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011462",
            "telephone_number": "435-840-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 GRANT AVE",
            "address_2": "APT 241",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011462",
            "telephone_number": "435-840-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWSON",
        "first_name": "AMANDA",
        "middle_name": "N",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Farris, ATC, LAT
• Matthew Owen Farthing, PT
• Clyde J Faucett, M.D.
• Kentin Fautin
• Jeffrey K. Favero, D.D.S.
• Lorell B Fawson, DPM
• Elise Brinson Fazio, DO
• Jean Fear
• Laurel A Fedor, M.D.
• Ian Feinauer, PH.D.

• All providers in Ogden, UT
• Independent Duty Medical Technicians in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.