Amanda N Pentiah

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

0805002593 Issued in VA

Practice address

10299 Woodman Rd
Glen Allen, VA 23060-4419

Phone

(804) 727-8500

Fax

(804) 727-8580

NPI assigned

Nov 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Henrico Area Mental Heatlh and Developmental Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Allen, VA
  • NPI 1023119773
  Medicare reassignment NPD

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1295558534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8500",
            "fax_number": "804-727-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8500",
            "fax_number": "804-727-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3908 Nine Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232234913",
            "country_code": "US",
            "telephone_number": "804-727-8100",
            "fax_number": "804-727-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENTIAH",
        "first_name": "AMANDA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0805002593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrics, Inc.
• Pediatrix Newborn Hearing Screen LLC
• Katherine Saehan Pellegrino
• Christen Pendleton, PSYD
• Kathleen Pennock, MS, PT
• Steven Perez Hernandez, BCBA, LBA
• Alvin Roosevelt Perry Jr.
• Peter Breslin MD LLC
• Sarah W Peters, SLP, CCC
• Ann Petersen, PHARM.D.

• Student in an Organized Health Care Education/Training Program in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.