Individual provider Active NPI

Amanda Grace Dancy, PA-C

  • Surgical Physician Assistant
  • Greensboro, NC
National Provider Identifier
1568467272
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
104075 Issued in NC
Practice address
509 N Elam Ave FL 2
Greensboro, NC 27403
Phone
(336) 274-1114
Fax
(336) 274-9638
NPI assigned
Jun 17, 2005
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 104075 NC
Surgical Physician Assistant 363AS0400X 104075 NC Primary

Addresses

Primary practice location

509 N Elam Ave FL 2
Greensboro, NC 27403

Mailing address

509 N Elam Ave FL 2
Greensboro, NC 27403-1157
Phone (336) 274-1114

Other names 1

  • Amanda Grace Yarbrough Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20040921000324 NC Practitioner - Physician Assistant 9537137229 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists of the Carolinas PLLCGroup PAC ID 0648178020, 78 clinicians
Alliance Urology SpecialistsGroup PAC ID 8921902586, 20 clinicians

Practice addresses (Care Compare)

509 N Elam Ave
FL 2
Greensboro, NC 27403-1157
Phone (336) 274-1114

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104075NCMDPhysician Assistant

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1568467272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N ELAM AVE FL 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031157",
            "telephone_number": "336-274-1114",
            "fax_number": "336-274-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N ELAM AVE FL 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27403",
            "telephone_number": "336-274-1114",
            "fax_number": "336-274-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCY",
        "first_name": "AMANDA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "104075",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "104075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "YARBROUGH",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.