Active NPI
Amanda Marie Knowles, PAC
- Physician Assistant
- Las Vegas, NV
National Provider Identifier
1841708385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1935
- Practice address
- 4570 S Eastern Ave
Suite #21
Las Vegas, NV 89119-6183 - Phone
- (702) 733-6033
- Fax
- (702) 733-7292
- NPI assigned
- Jan 18, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | PA1935 | NV | |
| Athletic Trainer | 2255A2300X | 0506285 | NV | |
| Physician Assistant | 363A00000X | PA1935 | NV | Primary |
Addresses
Primary practice location
4570 S Eastern Ave
Suite #21
Las Vegas, NV 89119-6183
Mailing address
4570 S Eastern Ave
Suite #21
Las Vegas, NV 89119-6183
Phone (702) 733-6033
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0506285 | NV | MD | Athletic Trainer |
| PA1935 | NV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dignity Health | Past | Accepting new patients | |
| Wee Care Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba St. Rose Dominican Hospital, Siena Campus
- General Acute Care Hospital
- Henderson, NV
- NPI 1770626426
-
- Pediatrics Physician
- Las Vegas, NV
- NPI 1518181841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680739200000",
"number": "1841708385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4570 S EASTERN AVE",
"address_2": "SUITE #21",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891196183",
"telephone_number": "702-733-6033",
"fax_number": "702-733-7292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4570 S EASTERN AVE",
"address_2": "SUITE #21",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891196183",
"telephone_number": "702-733-6033",
"fax_number": "702-733-7292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLES",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-18",
"last_updated": "2023-04-06",
"certification_date": "2023-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NV",
"license": "PA1935",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NV",
"license": "0506285",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA1935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.