Amanda N Douglas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA55843 Issued in CA

Practice address

1908 N Beale Rd Ste E
Marysville, CA 95901-6937

Phone

(530) 743-6888

Fax

(530) 743-9823

NPI assigned

Aug 6, 2018

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 KY

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baptist Health Medical Group Inc

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922401611

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System Inc

  dba Baptist Health Hardin

  • General Acute Care Hospital
  • Elizabethtown, KY
  • NPI 1689282147
  Care Compare affiliation

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1386122869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N BEALE RD STE E",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959016937",
            "telephone_number": "530-743-6888",
            "fax_number": "530-743-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N BEALE RD STE E",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959016937",
            "telephone_number": "530-743-6888",
            "fax_number": "530-743-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "AMANDA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Dodge
• Greg Kenneth Doglio I
• Sarah Dominic-Cluck
• Matthew Donnelly, M.D.
• Dorothy Faye Alexander (GRANNY'S HOUSE - Magnolia Rd)
• Brittney C Dozier
• Samantha Duarte Navarrete
• Marineli Jovel Magno Duatin, OTD, OTR/L
• Francisca Ines Duenas, M.S., LMFT
• Jennifer Ann Duncan, N.P

• Physician Assistant in Marysville, CA
• Providers in Marysville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.