Individual provider Active NPI

Amanda M Wonnacott, M.D.

  • Internal Medicine Physician
  • York, PA
National Provider Identifier
1801087754
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD436414 Issued in PA
Practice address
1001 S George St
3Rd Floor
York, PA 17403-3676
Phone
(717) 812-4005
Fax
(717) 812-2495
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL17067 OR
Internal Medicine Physician 207R00000X MD436414 PA Primary

Addresses

Primary practice location

1001 S George St
3Rd Floor
York, PA 17403-3676

Mailing address

108 E Corral Ave
Soldotna, AK 99669-7524
Phone (907) 714-5640

Other identifiers 2

IdentifierTypeStateIssuer
102307636MedicaidPA
2103270OtherPAHIGHMARK BLUE SHIELD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL17067ORMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1801087754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E CORRAL AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697524",
            "telephone_number": "907-714-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE ST",
            "address_2": "3RD FLOOR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033676",
            "telephone_number": "717-812-4005",
            "fax_number": "717-812-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONNACOTT",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "LL17067",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD436414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102307636",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2103270",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.