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Physician Compare National (NPI:1104311141)

HEALTHCARE PROVIDER: AMANDA BYERS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1104311141
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9931520392
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20200610003534
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BYERS
Individual professional last name
Provider First Name AMANDA
Individual professional first name
Provider Middle Name NAPPIER
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2017
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name AMNESTY HEALTH GROUP LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 6406100320
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 6
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 418 TOWN PARK BLVD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 1A
Group Practice or individual's line 2 address
City EVANS
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 308093492
Group Practice or individual's zip code (9 digits when available)
Phone Number 7064962685
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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