Individual provider Active NPI

Amanda Sappington, O.D.

  • Optometrist
  • Canyon, TX
National Provider Identifier
1104178763
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8095T Issued in TX
Practice address
3406 4TH Ave Unit B
Canyon, TX 79015-4357
Phone
(806) 884-2743
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8095T TX Primary

Addresses

Primary practice location

3406 4TH Ave Unit B
Canyon, TX 79015-4357

Mailing address

3406 4TH Ave Unit B
Canyon, TX 79015-4357
Phone (806) 884-2743

Other practice location 1

4612 S Coulter St
Amarillo, TX 79119-6403
Phone (806) 677-0175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130427000155 TX Practitioner - Optometry 3173769775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3406 4TH Ave
Unit B
Canyon, TX 79015-4357
Phone (806) 884-2743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8095TXMDChiropractor
8095TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Espy Vision, PLLC Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Medical Center Eye Associates, P.a. Optometrist CurrentSince Mar 11, 2017 Accepting new patients
Jimmy Wadley Eye Care PA PastSince Nov 1, 2015 Accepting new patients

Locations

1900 S Coulter St
Ste I
Amarillo, TX 79106
Phone (806) 355-9411

3406 4th Ave
Unit B
Canyon, TX 79015
Phone (806) 884-2743

Organizations & group practices 3

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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1104178763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 4TH AVE UNIT B",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154357",
            "telephone_number": "806-884-2743",
            "fax_number": "806-677-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 4TH AVE UNIT B",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154357",
            "telephone_number": "806-884-2743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4612 S Coulter St",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791196403",
            "country_code": "US",
            "telephone_number": "806-677-0175",
            "fax_number": "806-677-0177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAPPINGTON",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8095T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon, TX

Sources for this page

Verify at the official NPI Registry.