Amanda Rae Loomis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1946 Issued in SC

Practice address

800 E Cheves St
Suite 480
Florence, SC 29506-2650

Phone

(843) 777-7900

Fax

(843) 777-7925

NPI assigned

Jun 12, 2013

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1376981316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-777-7900",
            "fax_number": "843-777-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST",
            "address_2": "SUITE 480",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062650",
            "telephone_number": "843-777-7900",
            "fax_number": "843-777-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMIS",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA1946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "286371",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8495247",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1745PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adnan Mufaddal Lokhandwala, MD
• Karen Madison Long, PH.D.
• Robert Long Jr., HIS
• Anita Jean Longan, RD
• Looking Glass Behavioral Health Associates LLC
• Lilliana Lopez, PSYD
• Lorie Loreman, DO
• William Dean Lorenz, MD
• Henry Otto Lorin, DMD
• Victoria Nicole Lott, PA-C

• Physician Assistant in Florence, SC
• Providers in Florence, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.