DR. AMANDA JANE SAMPLE (NPI# 1043449820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043449820 |
Entity Type | Individual |
Full Name | DR. AMANDA JANE SAMPLE |
Credential | M.D. |
Practice Address |
2990 Mack Rd Ste 110 Fairfield OH 45014-5383 |
Practice Telephone | 5136038897 |
Practice Fax Number | 5138707172 |
Mailing Telephone | 5136038897 |
Mailing Fax Number | 5138707172 |
Enumeration Date | 2009-07-14 |
Last Update Date | 2018-12-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831409713 | Amanda E Sample | Case Manager/Care Coordinator | 5 Cumloden Dr, Falmouth, MA 02540-1605 | 2010-10-13 |
1891195137 | Amanda Sample | Pharmacist | 10580 W Ustick Rd, Store #5184, Boise, ID 83704-5267 | 2014-08-22 |
Street Address |
2990 MACK RD STE 110 |
City | FAIRFIELD |
State | OH |
Zip Code | 45014-5383 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558327445 | Mercy Ambulatory Surgery Center Ltd | Clinic/Center | 2990 Mack Rd, Fairfield, OH 45014-5383 | 2006-04-21 |
1457490872 | Hsc Surgical Associates | Clinic/Center | 2990 Mack Rd, Suite 203, Fairfield, OH 45014-5383 | 2007-02-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
Find all providers in zip 45014 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407466493 | Lizbeth Padilla | Student in an Organized Health Care Education/Training Program | 1125 Hayes St, Fairfield, CA 94533-4707 | 2020-08-04 |
1003426024 | Rebecca M Dance | Student in an Organized Health Care Education/Training Program | 5752 David Pl, Fairfield, OH 45014-3508 | 2020-08-04 |
1942819826 | Lauren J Cotton | Student in an Organized Health Care Education/Training Program | 1073 North Benson Road, Fairfield, CT 06824 | 2020-07-28 |
1396368585 | Sadek Debwan | Student in an Organized Health Care Education/Training Program | 2813 Shelter Hill Dr, Fairfield, CA 94534-8628 | 2020-05-21 |
1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
1023647989 | Maggie Giambalvo | Student in an Organized Health Care Education/Training Program | 752 Towne House Rd, Fairfield, CT 06824-1819 | 2020-04-03 |
1518503689 | Greta Jones | Student in an Organized Health Care Education/Training Program | 855 Mcglaughlin Rd, Fairfield, PA 17320-9002 | 2019-11-22 |
1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
1427600550 | Nancy Ivette Bocanegra | Student in an Organized Health Care Education/Training Program | 1607 Clay St, Fairfield, CA 94533-3808 | 2019-07-09 |
1013481316 | Raquel Marie Divincenzo | Student in an Organized Health Care Education/Training Program | 5151 Park Ave # Mc1425, Fairfield, CT 06825-1090 | 2019-01-20 |
Find all providers in FAIRFIELD |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.