Amanda Jane Cummins, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.005861RX Issued in OH

Practice address

109 Plaza Dr
Saint Clairsville, OH 43950-7713

Phone

(740) 695-2090

Fax

(740) 695-4116

NPI assigned

May 9, 2011

Last updated

Apr 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1851683916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PLAZA DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439507713",
            "telephone_number": "740-695-2090",
            "fax_number": "740-695-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PLAZA DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439507713",
            "telephone_number": "740-695-2090",
            "fax_number": "740-695-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINS",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005861RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "01358",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352672",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Staci Renae Crum
• Luke Xueliang Cui, MD PHD
• Cumberland Trail Fire District No 4 (Cumberland Trail Fire District)
• Kimberly Lynn Cumberledge, LPN
• Devon L Cummings, PH.D.
• Jennifer Cunningham, CDCA
• Jennifer Ann Cunningham
• Miranda Cunningham
• Amy Cupp, RN
• Rodney Lee Curtis II, MD

• Physician Assistant in Saint Clairsville, OH
• Providers in Saint Clairsville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.