Amanda K Nixon PA-C PC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

AMANDA K NIXON PA-C PC

Practice address

202 S Howard St
Tustin, MI 49688-5123

Phone

(231) 465-4165

Fax

(231) 465-4315

NPI assigned

Jun 22, 2017

Last updated

Aug 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Nixon, PA-CNPI 1912250861

Title

Owner

Phone

(231) 920-1875

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Amanda K Nixon PA-C PC

  • Rural Health Clinic/Center
  • Tustin, MI
  • NPI 1578072591

  O20170731003739

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Nixon

  • Medical Physician Assistant
  • Tustin, MI
  • NPI 1912250861
  Authorized official Same address or phone

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1083134886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "city": "TUSTIN",
            "state": "MI",
            "postal_code": "496880074",
            "telephone_number": "231-465-4165",
            "fax_number": "231-465-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S HOWARD ST",
            "city": "TUSTIN",
            "state": "MI",
            "postal_code": "496885123",
            "telephone_number": "231-465-4165",
            "fax_number": "231-465-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA K NIXON PA-C PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-920-1875",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda K Nixon PA-C PC
• Asmc II, PLLC
• Audrey Cooper
• Caitlin Deboard, LMSW
• Abigail Dawn Dennis

• Physician Assistant in Tustin, MI
• Providers in Tustin, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.