Amanda Maria Bahnam, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA5867 Issued in TN

Practice address

647 Dunlop LN Ste 210
Clarksville, TN 37040-5165

Phone

(931) 502-3810

Fax

(931) 502-2512

NPI assigned

Dec 28, 2023

Sex

Female

Sole proprietor

No

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.

• Saint Thomas Medical Partners

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669

  TN

  Medicare reassignment Care Compare group NPD
• Clarksville Physician Services LLC

  • General Practice Physician
  • Clarksville, TN
  • NPI 1083657829

  Physician Assistant, TN

  Medicare reassignment NPD

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Thomas Medical Partners 588 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.bahnam.1@7654.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 22, 2024.

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1013786219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN STE 210",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "931-502-3810",
            "fax_number": "931-502-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN STE 210",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "931-502-3810",
            "fax_number": "931-502-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHNAM",
        "first_name": "AMANDA",
        "middle_name": "MARIA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA5867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittnye Bagatini
• Chelsea Baggett, CCC-SLP
• Emma Katherine Baggett
• Jennifer Leigh Bagwell, NP
• Sherry Bagwell, SLP-CCC
• April Letrease Bailey
• Coursheka Bailey
• Courtney Bailey, DPT
• David Samuel Bailey, D.D.S.
• Margaret Kathleen Bailey

• All providers in Clarksville, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.