Active NPI
Amanda Collins, PA-C
- Physician Assistant
- Tiptonville, TN
National Provider Identifier
1366648735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 315
- Practice address
- Northwest Corrections
Tiptonville, TN 38079 - Phone
- (731) 253-5000
- NPI assigned
- Jun 22, 2007
- Last updated
- Jul 8, 2007
- 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 | 315 | TN | Primary |
Addresses
Primary practice location
Northwest Corrections
Tiptonville, TN 38079
Mailing address
4275 Lenox Nauvoo Rd
Dyersburg, TN 38024-6113
Phone (731) 286-6644
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 315 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366648735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4275 LENOX NAUVOO RD",
"city": "DYERSBURG",
"state": "TN",
"postal_code": "380246113",
"telephone_number": "731-286-6644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NORTHWEST CORRECTIONS",
"city": "TIPTONVILLE",
"state": "TN",
"postal_code": "38079",
"telephone_number": "731-253-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "AMANDA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tiptonville, TN
- Astin Berry, PTA
- Blue Ribbon Dental Center LLC
- Daniel W. Bruce, M.D.
- Cinderella Wigs & Breast Prosthetics
- Citizens of Lake County for Health Care Inc (Lake County Primary Care)
- County of Lake (Lake County Emergency Medical Service)
- Kristen Deaton, PMHNP-BC
- Kerri A Ervin, FNP
- Courtney Faught, APN
- Colton Edward Gramse, DNP, APRN, PMHNP-BC
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.