Individual provider Active NPI

Amanda S Rathburn, PA

  • Physician Assistant
  • Plainwell, MI
National Provider Identifier
1750716593
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006747 Issued in MI
Practice address
345 Naomi St
Plainwell, MI 49080-1257
Phone
(269) 552-0100
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006747 MI Primary

Addresses

Primary practice location

345 Naomi St
Plainwell, MI 49080-1257

Mailing address

5943 Stadium Dr
Ste 1
Kalamazoo, MI 49009-3016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140102001086 MI Practitioner - Physician Assistant 2062640717 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Hospital CurrentSince Oct 21, 2013 Accepting new patients
Ascension Borgess Hospital CurrentSince Oct 21, 2013 Accepting new patients

Locations

345 Naomi St
Plainwell, MI 49080
Phone (269) 552-0100

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.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1750716593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "address_2": "STE 1",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NAOMI ST",
            "city": "PLAINWELL",
            "state": "MI",
            "postal_code": "490801257",
            "telephone_number": "269-552-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHBURN",
        "first_name": "AMANDA",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainwell, MI

Sources for this page

Verify at the official NPI Registry.