Mary Amanda Fitzgerald, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-6099 Issued in AR

Practice address

5701 Summerhill Rd
Texarkana, TX 75503-1634

Phone

(870) 779-2751

Fax

(054) 456-7651

NPI assigned

Feb 8, 2006

Last updated

Jun 21, 2024By 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 1

Addresses

Other identifiers 2

Other names 1

• Dr. Mary Amanda Jackson Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Geriatric Health Services, Inc.

  • Specialist
  • Kansas City, MO
  • NPI 1558387159
  NPD (past)
• Geriatric Healthcare Services, LLC

  • Specialist
  • Kansas City, MO
  • NPI 1164607107
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1730152000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1848",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531841",
            "telephone_number": "479-437-3449",
            "fax_number": "479-437-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031634",
            "telephone_number": "870-779-2751",
            "fax_number": "054-456-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MARY",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-6099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183760001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202875852",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JACKSON",
            "middle_name": "AMANDA",
            "prefix": "DR.",
            "credential": "MD, MHSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeanne A Field Miller, MS, LPC, LMFT, LCDC,
• Vanessa Fields
• First Choice Urgent Care Clinic, PLLC (Exceed Urgent Care)
• Hannah Fitch
• Justin G. Fitts, C.R.N.A.
• Aileen Ann Fitzpatrick, PT, DPT
• Kellie Lyn Flaherty, PA
• John Charles Flint
• Steven W. Foltz, FNP-BC
• Sher Lynn Fomby, NP-C

• Internal Medicine Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.