AMANDA MAYNARD (NPI# 1457829475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457829475 |
| Entity Type | Individual |
| Full Name | AMANDA MAYNARD |
| Practice Address |
41 Brewster Rd Bristol CT 06010-5161 |
| Practice Telephone | 8605853433 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2019-05-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 79 Hepworth St, Bristol, CT 060107806 | 8603020217 | |
| 41 Brewster Rd, Bristol, CT 060105161 | 8605853433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952712317 | Amanda Maynard | Developmental Therapist | 33 Turnpike Rd, Southborough, MA 01772-2108 | 2014-05-19 |
| 1518388735 | Amanda Mischelle Maynard | Counselor | 2409 Homer Clayton Dr, Guntersville, AL 35976-2207 | 2013-12-16 |
| 1295166932 | Amanda Maynard | Physical Therapist | 1155 Atwater Ave, Circleville, OH 43113-1301 | 2013-12-05 |
| 1114279635 | Amanda Lynn Maynard | Nurse Practitioner | 428 E Main St, Inez, KY 41224-8931 | 2012-10-08 |
| 1487902896 | Amanda Maynard | Psychologist | 9650 Zelzah Ave, Northridge, CA 91325-2003 | 2012-08-16 |
| 1902181027 | Amanda R Maynard | Pharmacist | 808 S Duluth Ave, Sturgeon Bay, WI 54235-3807 | 2011-10-20 |
| 1457559171 | Amanda Diane Maynard | Internal Medicine | 500 E Main St, Suite 100, Columbus, OH 43215-5369 | 2007-07-03 |
| Street Address |
41 BREWSTER RD |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010-5161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004977 | Kara A Lynch | Physician Assistant | 41 Brewster Rd, Bristol, CT 06010-5161 | 2005-06-23 |
| 1881294486 | Gretchen Holloway | Nurse Practitioner | 41 Brewster Rd, Bristol, CT 06010-5141 | 2020-11-01 |
| 1275133969 | Bristol Health Pharmacy, LLC | Pharmacy | 41 Brewster Rd, Bristol, CT 06010-5161 | 2020-10-30 |
| 1992311195 | Davina Dube | Family Medicine | 41 Brewster Rd, Bristol, CT 06010-5141 | 2020-09-22 |
| 1215549142 | Danielle Sarah Desmarais | Physician Assistant | 41 Brewster Rd, Bristol, CT 06010-5161 | 2020-08-21 |
| 1770192726 | Elina Tannenbaum | Registered Nurse | 41 Brewster Rd, Bristol, CT 06010-5161 | 2020-07-27 |
| 1093331670 | Kendra Jade Mcgregor | Physician Assistant | 41 Brewster Rd, Bristol, CT 06010-5141 | 2020-06-19 |
| 1043832066 | Michael Owen Richards | Internal Medicine | 41 Brewster Rd, Bristol, CT 06010-5161 | 2020-05-13 |
| 1093354953 | Erica Stolarz | Physician Assistant | 41 Brewster Rd, Bristol, CT 06010-5141 | 2019-12-24 |
| 1336703511 | Rachel Driscoll | Dietitian, Registered | 41 Brewster Rd, Bristol, CT 06010-5161 | 2019-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457991309 | A New Hope Caregiving Alliance LLC | Home Health | 225 North Main Street - Suite 107, Bristol, CT 06010 | 2020-01-08 |
| 1154981777 | Georgianna Sloate Lmft, LLC | Marriage & Family Therapist | 38 Kelley Street, Bristol, CT 06010 | 2019-06-17 |
| 1962062810 | Ariel Morley | Urology | 15 Riverside Avenue, Bristol, CT 06010 | 2019-06-13 |
| 1013439488 | Theresa Rose Manolitsis | Student in an Organized Health Care Education/Training Program | 170 Pondview Lane, Bristol, CT 06010 | 2017-07-07 |
| 1588103600 | Elizabeth Anne Costello | Pharmacist | 747 Pine Street, Bristol, CT 06010 | 2017-02-22 |
| 1992157903 | Aiman Riaz | Internal Medicine | 41 Brewster Rd # 5161, Bristol, CT 06010 | 2016-07-01 |
| 1346609955 | Monika Magdalena Sullivan | Nurse Practitioner | 122 Maple Street, Bristol, CT 06010 | 2016-02-11 |
| 1346660776 | Peter Bellezza | Podiatrist | 15 Riverside Ave, Bristol, CT 06010 | 2014-04-24 |
| 1487088001 | Stephen Alexander Merwin | Social Worker | 32 Laird Drive, Bristol, CT 06010 | 2013-08-30 |
| 1215369574 | In Kyung Lee | Dentist | 1192 Farmington Ave., Bristol, CT 06010 | 2013-08-08 |
| Find all providers in zip 06010 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518510940 | Shanna Fielding | Physician Assistant | 181 Prospect St, Bristol, NH 03222-3021 | 2019-07-24 |
| 1023461605 | Ashley Anne Proulx | Physician Assistant | 22 Pine St Ste 104, Bristol, CT 06010-6949 | 2016-07-19 |
| 1184029761 | Lucilita Salvador | Physician Assistant | 11064 Nw Dempsey Barron Rd, Bristol, FL 32321-2622 | 2014-10-25 |
| 1831472067 | Timothy Michael Leicht | Physician Assistant | 335 Radcliffe St., Physician Assistant Surgical Associates, LLC, Bristol, PA 19007 | 2011-09-23 |
| 1194842336 | Jacqueline Sanz | Physician Assistant | 1 Brewster Road, Bristol, CT 06010-5142 | 2007-03-23 |
| 1477515625 | Charles Barnicoat | Physician Assistant | Bristol Hospital, Bristol, CT 06011 | 2006-04-04 |
| 1497722649 | Jodi Elizabeth Walsh | Physician Assistant | 61 Bradley St Ste 7, Bristol, CT 06010-5103 | 2006-03-07 |
| 1508857194 | Robert G Holzhauer | Physician Assistant | 539 Farmington Ave, Bristol, CT 06010-3931 | 2005-11-02 |
| 1922004977 | Kara A Lynch | Physician Assistant | 41 Brewster Rd, Bristol, CT 06010-5161 | 2005-06-23 |
| 1124637905 | Caroline Grace Derrick | Physician Assistant | 271 Medical Park Blvd, Bristol, TN 37620-7455 | 2020-07-28 |
| Find all providers in BRISTOL | ||||
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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.