Amy Marie Allen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103939 Issued in NC

Practice address

3209 Colonial Dr
Columbia, SC 29203-6930

Phone

(803) 434-6113

Fax

(803) 434-4277

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Amy A Tipton Other name

Medicare fee-for-service enrollment

Enrolled in SC

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

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 and National Provider Directory roles.

• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321
  Medicare reassignment
• Springwood Lake Primary Care, LLC

  • Clinic/Center
  • Columbia, SC
  • NPI 1841797081
  Medicare reassignment
• Prisma Health Medical Group-Midlands

  • Plastic and Reconstructive Surgery Physician
  • Sumter, SC
  • NPI 1447749510
  NPD
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1386715399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 HARDEN STREET EXT",
            "address_2": "15 MEDICAL PARK",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036894",
            "telephone_number": "803-545-5017",
            "fax_number": "803-255-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036930",
            "telephone_number": "803-434-6113",
            "fax_number": "803-434-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103939",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2373",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901642",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2288PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "TIPTON",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melanie Nicole All, APRN
• Rachel Ahn Allan, MD
• Allcare Consulting & Medical LLC
• Brienne Allen Schaeffer, PHD
• Sabrina Allen-Willis, RBT
• Aneshia D Allen
• Cassandra C Allen, MHA, RDCS, RVT
• Chandra Allen, PHARMD
• Crystal Allen, APRN
• Danielle Allen, ED.S

• Physician Assistant in Columbia, SC
• Providers in Columbia, 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 3, 2015; 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.