Individual provider Active NPI

Amy T Neal, PA-C

  • Physician Assistant
  • Keene, NH
National Provider Identifier
1124551718
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1254 Issued in NH
Practice address
580 Court Street
The Cheshire Medical Center
Keene, NH 03431
Phone
(603) 354-5454
Fax
(603) 354-6535
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1254 NH Primary

Addresses

Primary practice location

580 Court Street
The Cheshire Medical Center
Keene, NH 03431

Mailing address

580 Court Street
The Cheshire Medical Center - Emergency Department
Keene, NH 03431-1718
Phone (603) 354-5454

Other names 1

  • Amy Tiffin Wilkinson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170511001656 NH Practitioner - Physician Assistant 1850678277 Reassigns benefits to 2 organizations
I20180131002836 VT Practitioner - Physician Assistant 1850678277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1254NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cheshire Medical Center CurrentSince Oct 27, 2017 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 27, 2017 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Feb 17, 2018 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Feb 17, 2018 Accepting new patients

Locations

580 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

17 Belmont Ave
Brattleboro, VT 05301
Phone (802) 257-8360

Organizations & group practices 6

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1124551718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 COURT STREET",
            "address_2": "THE CHESHIRE MEDICAL CENTER - EMERGENCY DEPARTMENT",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311718",
            "telephone_number": "603-354-5454",
            "fax_number": "603-354-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT STREET",
            "address_2": "THE CHESHIRE MEDICAL CENTER",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "03431",
            "telephone_number": "603-354-5454",
            "fax_number": "603-354-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "AMY",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "WILKINSON",
            "middle_name": "TIFFIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.