Active NPI
Amy Elizabeth Justa, PA-C
- Physician Assistant
- Kalamazoo, MI
National Provider Identifier
1285682658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601004643
- Practice address
- 4201 W Michigan Ave
Kalamazoo, MI 49006-5810 - Phone
- (269) 372-1200
- Fax
- (269) 372-1279
- NPI assigned
- May 5, 2006
- Last updated
- Aug 16, 2010
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601004643 | MI | Primary |
Addresses
Primary practice location
4201 W Michigan Ave
Kalamazoo, MI 49006-5810
Mailing address
4201 W Michigan Ave
Kalamazoo, MI 49006-5810
Phone (269) 372-1200
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601004643 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281916800000",
"number": "1285682658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 W MICHIGAN AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490065810",
"telephone_number": "269-372-1200",
"fax_number": "269-372-1279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 W MICHIGAN AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490065810",
"telephone_number": "269-372-1200",
"fax_number": "269-372-1279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUSTA",
"first_name": "AMY",
"middle_name": "ELIZABETH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2010-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601004643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.