Amanda Nicole Pursifull, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

705 N 12TH St
Middlesboro, KY 40965-1987

Phone

(606) 248-0064

NPI assigned

Aug 25, 2022

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

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dubin Orthopaedic Centre, P.S.C.Group PAC ID 6103922331, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.pursifull@442.securemail.mdnavigatorclinical.com

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.

• Dubin Orthopaedic Centre, P.S.C.

  • Clinic/Center
  • Middlesboro, KY
  • NPI 1467596585
  Medicare reassignment Care Compare group
• Dubin Orthopaedic Centre, PSC

  • Prosthetic/Orthotic Supplier
  • Middlesboro, KY
  • NPI 1003013871
  NPD
• Dubin Orthopedic Centre PSC

  • Nurse Practitioner
  • Middlesboro, KY
  • NPI 1649601725
  NPD (past)

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1922727601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352",
            "city": "ARJAY",
            "state": "KY",
            "postal_code": "409020352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N 12TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651987",
            "telephone_number": "606-248-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURSIFULL",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinnacle of Purpose
• Ouen Pongdee, MD PSC INC
• Makenzie Prater
• Premier Medical Associates LLC
• Professional Family Healthcare Inc
• Brent Byron Pursifull, DMD
• Nicole Pursifull, NP
• Alayna Nicole Rangel, DC
• Douglas Eugene Redmond
• Rehabilitation Drug Services Inc

• Medical Physician Assistant in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.

Verify at the official NPI Registry.