Amanda Beau Lucas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2025023979 Issued in MO

Practice address

2011 Corona Rd Ste 207
Columbia, MO 65203-2548

Phone

(573) 234-1000

Fax

(573) 234-1771

NPI assigned

May 23, 2007

Reactivated

Sep 4, 2024

Last updated

May 21, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Cayce Dermatology Center and Medical Spa, PC

  dba DeSpain Cayce Dermatology Center

  • Dermatology Physician
  • Columbia, MO
  • NPI 1326162538
  Medicare reassignment NPD

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1639389703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 CORONA RD STE 207",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032548",
            "telephone_number": "573-234-1000",
            "fax_number": "573-234-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 CORONA RD STE 207",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032548",
            "telephone_number": "573-234-1000",
            "fax_number": "573-234-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "AMANDA",
        "middle_name": "BEAU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "deactivation_date": "2020-07-28",
        "reactivation_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025023979",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2006039114",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Tallio Lowery, APRN-BC, FNP
• Lea Ann Lowery, OT
• Timothy S Loy, MD
• Tawny Loyd, PA-C
• Bo Lu, MD, PHD
• David Edward Lucas
• Jeannie A Lucas, MSN FNP
• Luke Wilson Lucas, M.D.
• Robert Thomas Lucas
• Lucena 2 LLC

• Physician Assistant in Columbia, MO
• Providers in Columbia, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.