Individual provider Active NPI

Amanda Alexis Vazquez

  • Adult Companion
  • Fairborn, OH
National Provider Identifier
1679208706
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
1383 Cimarron Cir
Fairborn, OH 45324-6207
Phone
(937) 802-6815
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X Primary

Addresses

Primary practice location

1383 Cimarron Cir
Fairborn, OH 45324-6207

Mailing address

1383 Cimarron Cir
Fairborn, OH 45324-6207
Phone (937) 802-6815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1679208706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 CIMARRON CIR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246207",
            "telephone_number": "937-802-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 CIMARRON CIR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246207",
            "telephone_number": "937-802-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "AMANDA",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.