Individual provider Active NPI

Andrew James Relph, D.O.

  • Pediatrics Physician
  • Amarillo, TX
National Provider Identifier
1275850406
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P6898 Issued in TX
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 414-9800
Fax
(806) 354-5689
NPI assigned
Apr 28, 2010
Last updated
May 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X P6898 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 Wallace Blvd
Amarillo, TX 79106-1708
Phone (806) 414-9800

Other identifiers 4

IdentifierTypeStateIssuer
200489500 AMedicaidOK
318025901MedicaidTX
318025902MedicaidTX
53225201MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20180606000730 ID Practitioner - Pediatric Medicine 4880835362 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P6898TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Pediatrics CurrentSince May 18, 2018 Accepting new patients
Texas Tech Univeristy Health Sciences Center Lubbock Current Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

Interoperability endpoints

  • Direct secure messaging: andrewrelph@texastech.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1275850406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9800",
            "fax_number": "806-354-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELPH",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P6898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200489500 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318025901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318025902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53225201",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.