Amanda Howington Ward, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002752 Issued in GA

Practice address

1605 Whitesville St
Lagrange, GA 30240-5903

Phone

(706) 882-5119

Fax

(706) 882-0270

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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 GA, AL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Columbus Plastic Surgery, P.C.

  • Specialist
  • Columbus, GA
  • NPI 1588786453
  Medicare reassignment
• Dermatology Specialists of Georgia, LLC

  • Dermatology Physician
  • Athens, GA
  • NPI 1437298957
  Medicare reassignment
• Southeastern Dermatology Group PA

  dba Dermatology Specialists

  • Dermatology Physician
  • Panama City, FL
  • NPI 1518972231

  AL, GA

  Medicare reassignment
• Cahaba Dermatology & Skin Health Center, LLC

  • Dermatopathology Physician
  • Hoover, AL
  • NPI 1619213204
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316059793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WHITESVILLE ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302405903",
            "telephone_number": "706-882-5119",
            "fax_number": "706-882-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 WHITESVILLE ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302405903",
            "telephone_number": "706-882-5119",
            "fax_number": "706-882-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "AMANDA",
        "middle_name": "HOWINGTON",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-2773)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Walgreen Co (Rite Aid #11769)
• Walgreen Co (Walgreens #09622)
• Lisa N. Wallace, LPTA
• Kevin R Ward, CRNP
• Alfred Antonio Ware, NEMT
• Amy Melissa Ware, PP
• Laqua'Sha Monique Warren, MSN, APRN, FNP-C
• John Paul Warrick Jr., DPM

• Physician Assistant in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.