Individual provider Active NPI

Amanda Nelson

  • Prosthetic/Orthotic Supplier
  • West Lake Hills, TX
National Provider Identifier
1457005126
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
101719 Issued in TX
Practice address
912 S Capital of Texas Hwy Ste 230
West Lake Hills, TX 78746-5242
Phone
(512) 551-9836
Fax
(512) 727-2153
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 101719 TX Primary

Addresses

Primary practice location

912 S Capital of Texas Hwy Ste 230
West Lake Hills, TX 78746-5242

Mailing address

912 S Capital of Texas Hwy Ste 230
West Lake Hills, TX 78746-5242
Phone (512) 551-9836

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

LicenseStateTypeSpecialty
101719TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest #1, LLC Prosthetic/Orthotic Supplier Current Accepting new patients
Southwest Prosthetics, LLC Prosthetic/Orthotic Supplier Current Accepting new patients
Southwest Prosthetics Austin Inc Prosthetic/Orthotic Supplier CurrentSince Feb 13, 2022 Accepting new patients

Locations

912 S Capital of Texas Hwy
Ste 230
West Lake Hills, TX 78746
Phone (512) 551-9836

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1457005126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S CAPITAL OF TEXAS HWY STE 230",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465242",
            "telephone_number": "512-551-9836",
            "fax_number": "512-727-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S CAPITAL OF TEXAS HWY STE 230",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465242",
            "telephone_number": "512-551-9836",
            "fax_number": "512-727-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.