AMANDA SHER FALLOS (NPI# 1225364748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225364748 |
| Entity Type | Individual |
| Full Name | AMANDA SHER FALLOS |
| Credential | PA-C |
| Practice Address |
3939 Central Pike Hermitage TN 37076-3499 |
| Practice Telephone | 6158832331 |
| Practice Fax Number | 6153911785 |
| Mailing Telephone | 6158832331 |
| Mailing Fax Number | 6153911785 |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2014-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1758 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH | 12328183 | 01 | |
| TN | GROUP TAX ID | 621798471 | 01 |
| TN | 1526983 | 05 |
| Street Address |
3939 CENTRAL PIKE |
| City | HERMITAGE |
| State | TN |
| Zip Code | 37076-3499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710968037 | Richard Y Pak | Family Medicine | 3939 Central Pike, Hermitage, TN 37076 | 2005-11-14 |
| 1184011835 | Khaisha Verdelle Gist | Family Medicine | 3939 Central Pike, Hermitage, TN 37076-3499 | 2015-04-21 |
| 1538479688 | Demetria Edwards | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2010-10-07 |
| 1023340809 | Michael Warren | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2010-02-04 |
| 1386712339 | Kari Hammer | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3410 | 2006-11-30 |
| 1255419255 | Summit Primary Care | Family Medicine | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-11-01 |
| 1295748408 | Kenneth Roy Henry | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-08-15 |
| 1508884875 | Matthew H Milligan | Family Medicine | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-07-17 |
| 1740225887 | Summit Primary Care | Non-Pharmacy Dispensing Site | 3939 Central Pike, Hermitage, TN 37076-3410 | 2006-06-20 |
| 1730161985 | Edward L King | Family Medicine | 3939 Central Pike, Hermitage, TN 37076 | 2005-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255996583 | Cassandra Renea Brown | Dietitian, Registered | 5653 Frist Blvd Suite 530, Hermitage, TN 37076 | 2019-05-02 |
| 1164979753 | Chelsea Douglas | Nurse Practitioner | 5565 Frist Boulevard, Hermitage, TN 37076 | 2016-09-01 |
| 1417333568 | Middle Tennessee Homes | Intermediate Care Facility, Mentally Retarded | 3207 Earhart Road, Hermitage, TN 37076 | 2015-07-30 |
| 1578944187 | Middle Tennesse Homes | Intermediate Care Facility, Mentally Retarded | 3209 Earhart Road, Hermitage, TN 37076 | 2015-06-10 |
| 1063835585 | Rachel Jane Morris | Occupational Therapist | 1621 Robindale Dr, Hermitage, TN 37076 | 2014-02-04 |
| 1427488154 | Earhart 1 | Intermediate Care Facility, Mentally Retarded | 3156 Earhart Rd, Nashville, TN 37076 | 2013-11-15 |
| 1669802393 | Tulip Grove #2 | Intermediate Care Facility, Mentally Retarded | 877 Tulip Grove Rd, Nashville, TN 37076 | 2013-11-15 |
| 1780014514 | Tulip Grove Road #1 | Intermediate Care Facility, Mentally Retarded | 869 Tulip Grove Rd, Nashville, TN 37076 | 2013-11-14 |
| 1215365440 | Hospital Based Medical Services of Tennessee-i PC | Physician Assistant | 5655 First Blvd, Hermitage, TN 37076 | 2013-10-25 |
| 1942545686 | Helping Hands Support Center, Inc. | Home Health | 4060 Andrew Jackson Pkwy #907, Hermitage, TN 37076 | 2012-12-06 |
| Find all providers in zip 37076 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649664368 | Nicole Recinos | Physician Assistant | 5651 Frist Blvd Ste 200, Hermitage, TN 37076-2056 | 2015-03-19 |
| 1467794198 | Angela Rose Reino | Physician Assistant | 2999 Presidential Blvd, Sharon Cardiology Specialists, Hermitage, PA 16148 | 2013-03-20 |
| 1457635724 | Samantha D Johnston | Physician Assistant | 3068 Innovation Way, Hermitage, PA 16148-7906 | 2011-10-05 |
| 1356625651 | Bethany Nicole Hill | Physician Assistant | 5651 Frist Blvd, Suite 200, Hermitage, TN 37076-2054 | 2011-10-05 |
| 1023340809 | Michael Warren | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2010-02-04 |
| 1497083455 | Dustin D Henegan | Physician Assistant | 1005 Campus Cir, Hermitage, PA 16148-7901 | 2009-12-02 |
| 1922274448 | Kristie Shumaker | Physician Assistant | 3068 Innovation Way, Hermitage, PA 16148-7906 | 2008-05-05 |
| 1386833036 | Elizabeth Elliott | Physician Assistant | 2999 Presidential Blvd, Hermitage, PA 16148-3689 | 2007-10-18 |
| 1295748408 | Kenneth Roy Henry | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-08-15 |
| 1174560114 | Donna Price | Physician Assistant | 2999 Presidential Blvd, Hermitage, PA 16148-3689 | 2006-05-31 |
| Find all providers in HERMITAGE | ||||
Please comment or provide details below to improve the information on AMANDA SHER FALLOS.
| 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.