Vickie Payne, PA-C
Individual provider Active NPI Physician Assistant · Amarillo, TX
NPI 1821399809 · NPPES record last updated Apr 1, 2021
Key facts
- NPI
- 1821399809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA06985 (TX)
- Practice address
- 7200 SW 45TH Ave Unit 14
Amarillo, TX 79109-5084 - Phone
- (806) 680-1900
- Fax
- (806) 513-6791
- NPI assigned
- Nov 8, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amarillo Urgent Care LLC
Practice addresses (Care Compare)
1915 S Coulter St
Amarillo, TX 79106-3705
Phone (806) 352-5400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110815000026 | TX | Practitioner - Physician Assistant | 8123297868 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FMC Medical Foundation, Inc | Physician Assistant | Past | Accepting new patients |
| FMC Clinics, P.a. | Physician Assistant | Past | Accepting new patients |
| Amarillo Primary Care PLLC | Past | Accepting new patients | |
| Family Medicine Centers Lab L P | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA06985 | TX | Yes |
Addresses
Primary practice location
7200 SW 45TH Ave Unit 14
Amarillo, TX 79109-5084
Mailing address
367 S Gulph Rd
Atn :Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (806) 680-1900
Other practice location 1
4510 Bell St
Amarillo, TX 79109-5714
Phone (806) 212-4835
Other practice location 2
301 North 23rd Street Suite C
Canyon, TX 79015-3028
Phone (806) 452-5522
Other practice location 3
2001 S. Coulter St Suite 2001
Amarillo, TX 79106-2521
Phone (806) 318-5777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282515004 | Medicaid | TX | |
| 1L5087 | Other | TX | PTAN |
Other providers in Amarillo, TX
- Laurie C Paxton
- Adrian P Pay
- Brenna Dawn Payne
- Joshua Payne
- Kenna D'Ann Payne
- Valeria Ellis Paz
- Krista Lee Peace
- Chad Pearson
- Merten Gene Pearson
- Paul C Pearson
All providers in Amarillo, TX · Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.