Active NPI
Amanda Mallory Spillman, PA-C
- Physician Assistant
- Crestview Hills, KY
National Provider Identifier
1881866689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2455
- Practice address
- 2845 Chancellor Dr
Crestview Hills, KY 41017-3418 - Phone
- (859) 301-2663
- Fax
- (859) 817-7841
- NPI assigned
- Apr 1, 2008
- Last updated
- Oct 14, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2455 | KY | Primary |
| Physician Assistant | 363A00000X | 50.002712RX | OH |
Addresses
Primary practice location
2845 Chancellor Dr
Crestview Hills, KY 41017-3418
Mailing address
560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663
Other practice location 1
4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-5441
Other practice location 2
85 N Grand Ave
Fort Thomas, KY 41075-4027
Phone (859) 572-3618
Other practice location 3
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 572-3617
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2626 Alexandria Pike
Suite 100
Highland Heights, KY 41076-1530
Phone (859) 301-2663
560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.13 of 100
- Quality
- 89.38
- Improvement activities
- 40
- Cost
- 79.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2455 | KY | MD | Physician Assistant |
| 50.002712RX | OH | MD | Physician Assistant |
Interoperability endpoints
- amallory291744@direct-prd.stelizabeth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthopaedic Surgery Physician
- Edgewood, KY
- NPI 1598714560
-
dba Compass Emergency Physicians
- Emergency Medicine Physician
- Edgewood, KY
- NPI 1841696739
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Edgewood, KY
- NPI 1467492421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791936000000",
"number": "1881866689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 S LOOP RD",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173405",
"telephone_number": "859-301-2663",
"fax_number": "859-817-7848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 CHANCELLOR DR",
"city": "CRESTVIEW HILLS",
"state": "KY",
"postal_code": "410173418",
"telephone_number": "859-301-2663",
"fax_number": "859-817-7841"
}
],
"practiceLocations": [
{
"address_1": "4900 Houston Rd",
"address_purpose": "LOCATION",
"city": "Florence",
"state": "KY",
"postal_code": "410424824",
"country_code": "US",
"telephone_number": "859-212-5441",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "85 N Grand Ave",
"address_purpose": "LOCATION",
"city": "Fort Thomas",
"state": "KY",
"postal_code": "410754027",
"country_code": "US",
"telephone_number": "859-572-3618",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Village Dr",
"address_purpose": "LOCATION",
"city": "Edgewood",
"state": "KY",
"postal_code": "410173403",
"country_code": "US",
"telephone_number": "859-572-3617",
"fax_number": "859-572-2326",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALLORY SPILLMAN",
"first_name": "AMANDA",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-01",
"last_updated": "2026-10-14",
"certification_date": "2026-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA2455",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.002712RX",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview Hills, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.