Individual provider Active NPI

Amanda Grace Estep, MD

  • Family Medicine Physician
  • Georgetown, KY
National Provider Identifier
1275978207
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01234 Issued in KY
Practice address
1138 Lexington Rd
Suite 130
Georgetown, KY 40324-9672
Phone
(502) 867-0222
Fax
(502) 867-0420
NPI assigned
May 3, 2013
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01234 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1138 Lexington Rd
Suite 130
Georgetown, KY 40324-9672

Mailing address

1138 Lexington Rd
Suite 130
Georgetown, KY 40324-9672
Phone (502) 867-0222

Other names 1

  • Amanda E Lane Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20160628003158 KY Practitioner - Family Practice 9133361009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
JC Edwards School of Medicine, Marshall University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Mso LLCGroup PAC ID 0749450633, 53 clinicians

Practice addresses (Care Compare)

1138 Lexington Rd
Suite 130
Georgetown, KY 40324-9673
Phone (502) 570-2324

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01234KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mso LLC Current Accepting new patients
Kentucky Mso, LLC Family Medicine CurrentSince Jul 15, 2016 Accepting new patients
Kentucky Mso LLC CurrentSince Jul 15, 2016 Accepting new patients
Kentucky Mso LLC Past Accepting new patients

Locations

105 Prather Path
Ste 1100
Georgetown, KY 40324
Phone (502) 603-5220

105 Prather Path
Ste 2400
Georgetown, KY 40324
Phone (502) 570-3767

1138 Lexington Rd
Ste 130
Georgetown, KY 40324
Phone (502) 570-2324

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660

Interoperability endpoints

  • Direct secure messaging: amanda_e_lane@yourcarecommunity.org
  • Direct secure messaging: amanda.lane.1@19475.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1275978207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON RD",
            "address_2": "SUITE 130",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249672",
            "telephone_number": "502-867-0222",
            "fax_number": "502-867-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON RD",
            "address_2": "SUITE 130",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249672",
            "telephone_number": "502-867-0222",
            "fax_number": "502-867-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEP",
        "first_name": "AMANDA",
        "middle_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "01234",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LANE",
            "middle_name": "E",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.