AMANDA JEAN REDDY (NPI# 1831345107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831345107 |
| Entity Type | Individual |
| Full Name | AMANDA JEAN REDDY |
| Other Name | AMANDA JEAN ROSS |
| Credential | P.A.-C |
| Practice Address |
550 Munson Ave Ste 202 Traverse City MI 49686-3580 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162672600 |
| Practice Fax Number | 6162672601 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601005331 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
550 MUNSON AVE STE 202 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686-3580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700852977 | Michael J Forness | Orthopaedic Surgery | 550 Munson Ave Ste 202, Traverse City, MI 49686-3580 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| 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 |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1922381995 | Emily E Seal | Physician Assistant | 1221 6th St Ste 208, Traverse City, MI 49684-2360 | 2011-09-26 |
| 1881896942 | Svea Perai Kayann Wikstrand | Physician Assistant | 13919 S West Bay Shore Dr, Ste G-01, Traverse City, MI 49684-6216 | 2007-06-01 |
| 1245340256 | Lori L. Hopkins | Physician Assistant | Bayside Allergy, 447 Munson Ave., Traverse City, MI 49686 | 2006-08-30 |
| 1417973231 | Kenneth H Warner | Physician Assistant | 3537 W Front St Ste E, Traverse City, MI 49684-7943 | 2006-07-14 |
| 1881650935 | Darnell B Ganley | Physician Assistant | 4075 Copper Ridge Dr, Traverse City, MI 49684-7059 | 2006-04-25 |
| 1942295274 | Karri Elizabeth Vaughan | Physician Assistant | 4624 N Spider Lake Rd, Traverse City, MI 49696-8440 | 2005-09-13 |
| 1003415118 | Munson Medical Center | Physician Assistant | 3074 N Us 31 S, Traverse City, MI 49684-4533 | 2020-10-20 |
| 1821611732 | Kathryn Mae Mcgowan | Physician Assistant | 4075 Copper Ridge Dr, Traverse City, MI 49684-7059 | 2020-05-26 |
| 1043845928 | Kolleen Werly | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2020-03-11 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
Please comment or provide details below to improve the information on AMANDA JEAN REDDY.
| 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.