Amanda Graefin Von Der Schulenburg, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

003997 Issued in GA

Practice address

5673 Peachtree Dunwoody Rd
Suite 870
Atlanta, GA 30342

Phone

(404) 255-2975

Fax

(404) 255-2276

NPI assigned

Dec 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amanda Loris Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1619951985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 870",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-255-2975",
            "fax_number": "404-255-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 870",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-255-2975",
            "fax_number": "404-255-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON DER SCHULENBURG",
        "first_name": "AMANDA",
        "middle_name": "GRAEFIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003997",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "003997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498718801A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILSON",
            "middle_name": "LORIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Volkert, PHD
• Theodore Henry Vollmer, RBT
• Faith Elizabeth Volpe, DDS
• Michael Paul Volpe, RPH
• Stephanie Volpini, P.T.
• Caroline Von Fluegge, D.C.
• Lucille Syracuse Von Roemer, CNP
• Carlee Shope Von Ruden
• Anna Austin Von, MD
• Breanna Vonachen, PA-C

• Surgical Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.