Individual provider Active NPI

Amanda Davis, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1508108556
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9106840 Issued in FL
Practice address
1800 Mercy Dr
Orlando, FL 32808-5646
Phone
(407) 875-3700
NPI assigned
Mar 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 11494 FL
Physician Assistant 363A00000X 9106840 FL Primary

Addresses

Primary practice location

1800 Mercy Dr
Orlando, FL 32808-5646

Mailing address

1800 Mercy Dr
Orlando, FL 32808-5646
Phone (407) 875-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11494FLMDRegistered Respiratory Therapist
9106840FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1363478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1508108556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MERCY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085646",
            "telephone_number": "407-875-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MERCY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085646",
            "telephone_number": "407-875-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-17",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "FL",
            "license": "11494",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9106840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.