Individual provider Active NPI

Amanda Bush Flynn, D.O.

  • Family Medicine Physician
  • Anderson, SC
National Provider Identifier
1265585541
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
874 Issued in SC
Practice address
2000 E Greenville St
Suite #2000
Anderson, SC 29621-1580
Phone
(864) 260-1590
NPI assigned
Jan 19, 2007
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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 874 SC Primary

Addresses

Primary practice location

2000 E Greenville St
Suite #2000
Anderson, SC 29621-1580

Mailing address

2000 E Greenville St
Suite #2000
Anderson, SC 29621-1580
Phone (864) 260-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051123000488 SC Practitioner - Family Practice 3375563059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
874SCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1265585541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E GREENVILLE ST",
            "address_2": "SUITE #2000",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211580",
            "telephone_number": "864-260-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E GREENVILLE ST",
            "address_2": "SUITE #2000",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211580",
            "telephone_number": "864-260-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "AMANDA",
        "middle_name": "BUSH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.