Active NPI
Ai Qin Amanda Chen, D.O.
- Family Medicine Physician
- Brady, TX
National Provider Identifier
1164802427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R8332
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| R8332 | TX | MD | Family 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.