Individual provider Active NPI

Amanda Dian Dooly

  • Physician Assistant
  • Fort Benning, GA
National Provider Identifier
1710718382
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13647 Issued in GA
Practice address
6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Phone
(762) 408-2273
NPI assigned
Aug 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA18493 TX
Physician Assistant 363A00000X 13647 GA Primary

Addresses

Primary practice location

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Mailing address

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adooly1370138@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241129000303 TX Practitioner - Physician Assistant 7416482328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2401 S 31 St
Temple, TX 76508-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13647GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott and White Clinic CurrentSince Nov 22, 2024 Accepting new patients
Phoebe Physician Group, Inc Past Accepting new patients

Locations

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Interoperability endpoints

  • Direct secure messaging: adooly1370138@direct.sw.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1710718382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLY",
        "first_name": "AMANDA",
        "middle_name": "DIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18493",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adooly1370138@direct.sw.org",
            "affiliation": "N",
            "address_1": "4501 S Clear Creek Rd",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765494218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Benning, GA

Sources for this page

Verify at the official NPI Registry.