Amanda Kathryn Wilcox, EDS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

10104196 Issued in IN

Practice address

10060 Brummitt Rd
Granger, IN 46530-7264

Phone

(574) 679-9788

NPI assigned

Oct 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Penn Harris Madison School Corporation

  • Local Education Agency (LEA)
  • Mishawaka, IN
  • NPI 1558494708
  NPD (past)

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1649098393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55900 BITTERSWEET RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465457798",
            "telephone_number": "574-259-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10060 BRUMMITT RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307264",
            "telephone_number": "574-679-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "AMANDA",
        "middle_name": "KATHRYN",
        "credential": "EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IN",
            "license": "10104196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wade Wenger
• Elizabeth A Weston-Hammang, MD
• Wheely Care Transportation
• Christina J White, CMT
• Hannah Nicole White
• Jana Sue Wilde, M.S.,CCC,SLP
• Cailey Anne Willhardt, OD
• Williams Family Chiropractic Clinic LLC
• Patrick Timothy Williams, D.D.S.
• Zac Williams, DC

• School Psychologist in Granger, IN
• Providers in Granger, IN by specialty
• School Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.