Individual provider Active NPI

Ai Qin Amanda Chen, D.O.

  • Family Medicine Physician
  • Brady, TX
National Provider Identifier
1164802427
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8332 Issued in TX
Practice address
2010 Nine Rd
Brady, TX 76825-7210
Phone
(325) 597-2114
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R8332 TX Primary

Addresses

Primary practice location

2010 Nine Rd
Brady, TX 76825-7210

Mailing address

396 Broadway
Kingston, NY 12401-4626
Phone (845) 802-7600

Other practice location 1

1 Family Practice Dr
Kingston, NY 12401-6449
Phone (845) 338-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R8332TXMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1164802427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 BROADWAY",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014626",
            "telephone_number": "845-802-7600",
            "fax_number": "845-338-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 NINE RD",
            "city": "BRADY",
            "state": "TX",
            "postal_code": "768257210",
            "telephone_number": "325-597-2114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Family Practice Dr",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124016449",
            "country_code": "US",
            "telephone_number": "845-338-6400",
            "fax_number": "845-339-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "AI QIN AMANDA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R8332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brady, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.