Amanda Leah Spahn, PA-C

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

PA-476 Issued in AR

Practice address

8101 McClure Dr Ste 100
Fort Smith, AR 72916-6044

Phone

(479) 459-6528

NPI assigned

May 8, 2012

Last updated

Mar 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  NPD (past)

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1558620856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 MCCLURE DR STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166044",
            "telephone_number": "479-459-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 MCCLURE DR STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166044",
            "telephone_number": "479-459-6528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 Rogers Ave",
            "address_2": "Keith Brown re: Amanda Spahn",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729034100",
            "country_code": "US",
            "telephone_number": "479-314-2947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAHN",
        "first_name": "AMANDA",
        "middle_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "P-T1217",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-476",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AR",
            "license": "PA-476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southside Medical Clinic
• Southside Specialty Pharmacy
• Southwest Neurologicl Institute PA
• Southwest Neuroloigical Institute,PA
• Tracy Souza
• Christen C Spain, LMT
• Monita Spann, CSFA
• Sparks Medical Foundatin (Waldron Place Internal Medicine)
• Sparks Medical Foundation (Surgical Associates of Ft. Smith)
• Sparks Medical Foundation (Sparks Occupational Medicine North)

• Gynecology Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Gynecology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.