Individual provider Active NPI

Tommy Mikal Amal

  • Driver
  • Blacksburg, VA
National Provider Identifier
1780079830
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
343900000X Issued in VA
Practice address
1999 S Main St
303-C
Blacksburg, VA 24060-6634
Phone
(773) 818-9052
NPI assigned
Apr 4, 2015
Last updated
Apr 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 343900000X VA Primary

Addresses

Primary practice location

1999 S Main St
303-C
Blacksburg, VA 24060-6634

Mailing address

1999 S Main St
303-C
Blacksburg, VA 24060-6634
Phone (773) 818-9052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
343900000XVAMDDriver

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1780079830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 S MAIN ST",
            "address_2": "303-C",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606634",
            "telephone_number": "773-818-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 S MAIN ST",
            "address_2": "303-C",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606634",
            "telephone_number": "773-818-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAL",
        "first_name": "TOMMY",
        "middle_name": "MIKAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-04",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "VA",
            "license": "343900000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.