Individual provider Active NPI

Amanda Rice, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1578114039
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009503 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-1329
NPI assigned
Sep 26, 2019
Last updated
Sep 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009503 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

45095 Fox Pointe Dr
Canton, MI 48187-2565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20191127000608 MI Practitioner - Physician Assistant 1759714074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

775 S Main St
Chelsea, MI 48118-1383

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601009503MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Nov 1, 2019 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Nov 1, 2019 Accepting new patients
Iha Health Service Corporation CurrentSince Sep 1, 2022 Accepting new patients
Iha Health Service Corporation Physician Assistant CurrentSince Sep 1, 2022 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: arice2078691@direct.trinity-health.org
  • Direct secure messaging: arive614214@direct.hfhs.org

Organizations & group practices 7

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 2

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": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1578114039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45095 FOX POINTE DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.