Individual provider Active NPI

Amy Jeannine Lenox, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1457407256
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3597 Issued in AZ
Practice address
2640 W Baseline Rd
Suite 111
Phoenix, AZ 85041-6492
Phone
(480) 677-8282
Fax
(480) 677-8283
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3597 AZ Primary
Medical Physician Assistant 363AM0700X 3597 AZ
Surgical Physician Assistant 363AS0400X 3597 AZ

Addresses

Primary practice location

2640 W Baseline Rd
Suite 111
Phoenix, AZ 85041-6492

Mailing address

4600 S Mill Av
Suite 280
Tempe, AZ 85282-6850
Phone (480) 305-2888

Other identifiers 1

IdentifierTypeStateIssuer
242309MedicaidAZ

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3597AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Livn, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1457407256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 S MILL AV",
            "address_2": "SUITE 280",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826850",
            "telephone_number": "480-305-2888",
            "fax_number": "480-305-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 W BASELINE RD",
            "address_2": "SUITE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416492",
            "telephone_number": "480-677-8282",
            "fax_number": "480-677-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENOX",
        "first_name": "AMY",
        "middle_name": "JEANNINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3597",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3597",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3597",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242309",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.