Active NPI
Amanda Lynn Houston
- Contractor
- Lake City, FL
National Provider Identifier
1821170705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 110 NW White Oak Glenn
Lake City, FL 32055 - Phone
- (386) 288-4474
- Fax
- (386) 755-3944
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | FL | Primary |
Addresses
Primary practice location
110 NW White Oak Glenn
Lake City, FL 32055
Mailing address
PO Box 381
Lake City, FL 32056-0381
Phone (386) 755-3944
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
| License | State | Type | Specialty |
|---|---|---|---|
| 679303796 | FL | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1821170705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 381",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320560381",
"telephone_number": "386-755-3944",
"fax_number": "386-755-3944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 NW WHITE OAK GLENN",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "32055",
"telephone_number": "386-288-4474",
"fax_number": "386-755-3944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "AMANDA",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.