Amanda M Vickers, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05530 Issued in KY

Practice address

309 11TH St
Carrollton, KY 41008-1435

Phone

(502) 732-4321

NPI assigned

Jul 18, 2013

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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 Osteopathy

State licenses

Practice roles

Locations

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.

• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667
  Medicare reassignment NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1770925794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410081435",
            "telephone_number": "502-732-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 11TH ST",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410081435",
            "telephone_number": "502-732-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "AMANDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018036866",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q1323",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200064469",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Three Rivers District Health Department
• Together in Care LLC
• Triad Health Systems Inc.
• Triad Health Systems, Inc. (Triad Health Systems Pharmacy)
• Kathryn Nicole Trueblood, PHARMD
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2968)
• Walgreen Co (Walgreens #17241)
• Marie C Wallace, LPCC
• Summer Louann Ward
• Ashley Washburn, LPCC

• Family Medicine Physician in Carrollton, KY
• Providers in Carrollton, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.