Active NPI
Amanda Nicole Hall, CRNA
- Certified Registered Nurse Anesthetist
- Dothan, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 802889
- Practice address
- 1108 Ross Clark Circle
Dothan, AL 36301-2911 - Phone
- (334) 793-8111
- NPI assigned
- Sep 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 802889 | TX | Primary |
Addresses
Primary practice location
1108 Ross Clark Circle
Dothan, AL 36301-2911
Mailing address
1108 Ross Clark Circle
Dothan, AL 36301-2911
Phone (334) 793-8111
Other names 1
- Amanda Nicole Stidham
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5304 | NC | MD | Pharmacist |
| 802889 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alta Anesthesia Associates of Georgia, PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Gi Anesthesia of Georgia LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Medcore Associates, PLLC | Current | Accepting new patients | |
| Pathology Laboratory Associates | Current | Accepting new patients | |
| Coastal Ambulatory Anesthesia LLC | Current | Accepting new patients | |
| Sentry Anesthesia Management, LLC | Current | Accepting new patients |
Locations
1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635
7956 Vaughn Rd
Ste 165
Montgomery, AL 36116
126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011
3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570
1955 Textile Way
Gainesville, GA 30501
Phone (678) 987-1499
2000 Dan Proctor Dr
Saint Marys, GA 31558
Phone (912) 576-6160
1139 Lexington Ave
Savannah, GA 31404
Phone (912) 303-4200
13040 Abercorn St
Ste 2
Savannah, GA 31419
Phone (912) 920-1998
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.
-
- Anesthesiology Physician
- Brunswick, GA
- NPI 1275504771
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Savannah, GA
- NPI 1750753786
-
- Certified Registered Nurse Anesthetist
- Gainesville, GA
- NPI 1326569187
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Newnan, GA
- NPI 1134544794
-
- Anatomic Pathology & Clinical Pathology Physician
- Dothan, AL
- NPI 1992524607
-
- Anatomic Pathology & Clinical Pathology Physician
- Dothan, AL
- NPI 1134190648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487030400000",
"number": "1134598881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 ROSS CLARK CIRCLE",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363012911",
"telephone_number": "334-793-8111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 ROSS CLARK CIRCLE",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363012911",
"telephone_number": "334-793-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "AMANDA",
"middle_name": "NICOLE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-23",
"last_updated": "2017-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "802889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "STIDHAM",
"middle_name": "NICOLE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Dothan, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.