Amanda Bush Flynn, D.O.

Key facts

NPI

1265585541

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

874 (SC)

Practice address

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

Phone

(864) 260-1590

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Osteopathy

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 14, 2010.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE3313",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008743",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Anderson, SC · Family Medicine Physician in South Carolina