Amanda Wickline

Primary specialty

HomemakerTaxonomy code 376J00000X

Practice address

4510 Pennsylvania Ave Ste C
Charleston, WV 25302-4835

Phone

(304) 965-9081

Fax

(304) 471-2488

NPI assigned

Sep 18, 2023

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

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1750169165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 RICH FORK RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253127259",
            "telephone_number": "304-989-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 PENNSYLVANIA AVE STE C",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253024835",
            "telephone_number": "304-965-9081",
            "fax_number": "304-471-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLINE",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Dawn Whittington, RD, LD
• Jeffery Lee Whittington, OD
• Mark Jeffery Whittington, OD
• Sandra H Whittington, OD
• Sarah Lynne Wick
• Lesle Beth Wickline, M.ED
• McKenzie Wickline
• Cathy Widener
• Janet Widener
• Marsha Lynn Wiersteiner, APRN, FNP-BC

• Homemaker in Charleston, WV
• Providers in Charleston, WV by specialty
• Homemaker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.