Individual provider Active NPI

Amanda Katlin Reid, PA

  • Physician Assistant
  • Fayetteville, AR
National Provider Identifier
1295158913
Registry record updated Sep 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-993 Issued in AR
Practice address
3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone
(479) 521-2752
Fax
(479) 521-4603
NPI assigned
Jan 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X PA-993 AR
Physician Assistant 363A00000X PA-993 AR Primary

Addresses

Primary practice location

3317 N Wimberly Dr
Fayetteville, AR 72703-4056

Mailing address

12804 Rhoden LN
Lowell, AR 72745-9198
Phone (417) 291-2816

Other practice location 1

609 W Maple Ave
Springdale, AR 72764-5335
Phone (479) 751-5711

Other names 1

  • Amanda Katlin Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210807000060 AR Practitioner - Physician Assistant 0941431480 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozark Orthopaedics, P.a.Group PAC ID 2860477189, 57 clinicians

Practice addresses (Care Compare)

1800 SE Moberly LN
Ozark Orthopaedics
Bentonville, AR 72712-7017
Phone (479) 521-2752

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

3352 N Futrall Dr
Fayetteville, AR 72703-4057
Phone (479) 521-2752

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as apm
Quality
79.26
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.39 of 100Reported as group
Quality
99.78
Improvement activities
0
Cost
78.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-993ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Orthopaedics, PA Orthopaedic Surgery CurrentSince Apr 1, 2024 Accepting new patients
South Arkansas Emergency Physicians, LLP Physician Assistant CurrentSince Jul 1, 2021 Accepting new patients
South Arkansas Emergency Physicians, LLP CurrentSince Jul 1, 2021 Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

3317 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 521-2752

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Interoperability endpoints

  • Direct secure messaging: amanda.reid.1@18403.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18403/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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

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": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757808000000",
    "number": "1295158913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12804 RHODEN LN",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727459198",
            "telephone_number": "417-291-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "609 W Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727645335",
            "country_code": "US",
            "telephone_number": "479-751-5711",
            "fax_number": "479-757-2919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "AMANDA",
        "middle_name": "KATLIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2025-09-14",
        "certification_date": "2025-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AR",
            "license": "PA-993",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DAVIS",
            "middle_name": "KATLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.