AMANDA GRAY CONNAN (NPI# 1851584593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851584593 |
| Entity Type | Individual |
| Full Name | AMANDA GRAY CONNAN |
| Credential | PA-C |
| Practice Address |
8725 N Wickham Rd Suite 302 Melbourne FL 32940-2239 |
| Mailing Address |
Po Box 561600 Rockledge FL 32956-1600 |
| Practice Telephone | 3214349230 |
| Practice Fax Number | 3214349231 |
| Mailing Telephone | 3214344600 |
| Mailing Fax Number | 3212590635 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2012-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9106972 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
005133 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9106972 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8725 N WICKHAM RD SUITE 302 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32940-2239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033101985 | Martin E Avalos | Internal Medicine | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-5997 | 2005-08-17 |
| 1457973968 | Amanda Baker | Pharmacist | 8725 N Wickham Rd, Melbourne, FL 32940-2239 | 2020-05-07 |
| 1861931198 | Health First Family Pharmacy | Pharmacy | 8725 N Wickham Rd, Suite 102, Melbourne, FL 32940-2239 | 2017-02-20 |
| 1790234219 | Megan Mcclain | Nurse Practitioner | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-2240 | 2016-09-26 |
| 1396143475 | Holmes Regional Medical Center, Inc. | Pharmacy | 8725 N Wickham Rd, Melbourne, FL 32940-2239 | 2014-12-05 |
| 1518207943 | Beth Ann Decordova | Nurse Practitioner | 8725 N Wickham Rd, 200, Melbourne, FL 32940-2239 | 2013-02-21 |
| 1700166378 | Health First Physicians, Inc | Orthopaedic Surgery | 8725 N Wickham Rd, Suite 301, Melbourne, FL 32940-2239 | 2011-08-26 |
| 1003132887 | Nathan D Allison | Surgery | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-2239 | 2010-04-19 |
| 1780812586 | Aimee Lynn Tieu | Obstetrics & Gynecology | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-2239 | 2009-06-30 |
| 1699982025 | Daniel Reynolds | Physical Therapist | 8725 N Wickham Rd, Suite 301, Melbourne, FL 32940-5997 | 2007-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700403649 | True Motion Physical Therapy and Wellness | Clinic/Center | 3536 Peninsula Circle, Mlebourne, FL 32940 | 2020-06-26 |
| 1568089431 | Live Gracefully Physio and Wellness, Pllc | Clinic/Center | 6470 Shadow Creek Trail, Apt 5204, Melbourne, FL 32940 | 2020-06-26 |
| 1295360592 | Hiteshi Patel | Pharmacist | 3134 Hummingbird Way, Melbourne, FL 32940 | 2020-03-06 |
| 1972133122 | Curtis Lynn Curbo | Social Worker | 3830 Fringetree Lane, Melbourne, FL 32940 | 2020-01-16 |
| 1861038283 | Medfast Urgent Care Centers, LLC | Clinic/Center | 5500 Stadium Parkway, Melbourne, FL 32940 | 2019-11-20 |
| 1134601594 | Caroline Grace Bennett | Behavior Technician | 5500 Murrell Rd Suite 100, Melbourne, FL 32940 | 2018-09-02 |
| 1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
| 1356849251 | Executive Non-emergency Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3155-02 Suntree Blvd, Melbourne, FL 32940 | 2018-01-25 |
| 1679081160 | Brevard Oaks Center, LLC | Skilled Nursing Facility | 2355 Vidina Drive, Viera, FL 32940 | 2018-01-18 |
| 1275045817 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 6340 N Wickham Rd Ste 101, Melbourne, FL 32940 | 2017-11-03 |
| Find all providers in zip 32940 | ||||
| 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 |
|---|---|---|---|---|
| 1164021895 | Breeyon Beachel | Physician Assistant | 4610 Beck Lake Trl Apt 1, Melbourne, FL 32901-8805 | 2020-10-23 |
| 1215535257 | Melissa Lee Amos | Physician Assistant | 3543 Providence Trace Dr, Melbourne, KY 41059-9203 | 2020-10-12 |
| 1720694326 | Michelle Smith | Physician Assistant | 2330 Andrea Ct, Melbourne, FL 32934-7601 | 2020-09-18 |
| 1093331787 | Alyssa Capawana | Physician Assistant | 6740 Shadow Creek Trl Apt 5410, Melbourne, FL 32940-6293 | 2020-06-18 |
| 1194359018 | Jarrod D Kearney | Physician Assistant | 580 N Wickham Rd Ste C, Melbourne, FL 32935-8400 | 2020-02-29 |
| 1104392851 | Rachel Margaret Martins | Physician Assistant | 1052 Fieldstone Dr, Melbourne, FL 32940-1633 | 2018-10-21 |
| 1497230320 | Mirabella M. Muller | Physician Assistant | 298 Michigan Ave Ste 101, Melbourne, FL 32901-3104 | 2018-09-26 |
| 1952743924 | Kristin Wagner | Physician Assistant | 2200 W. Eau Gallie Blvd., Suite 202c, Melbourne, FL 32935-3166 | 2013-07-19 |
| 1538485941 | David Luke Brightwell | Physician Assistant | 54 Tate Springs Rd, Melbourne, AR 72556-8633 | 2010-04-09 |
| 1679808588 | Maycie A Cruz | Physician Assistant | Family Practice of Suntree and Viera, 2 Suntree Place, Melbourne, FL 32940 | 2009-10-09 |
| Find all providers in MELBOURNE | ||||
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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.