MEDICARE: MELANIE ANN MCAMIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	5503	TN
2	363AS0400X	Surgical Physician Assistant	5503	TN

General Provider Information

NPI Number	:	1154077766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE ANN MCAMIS

Provider Business Mailing Address
First Line	:	1021 W OAKLAND AVE STE 310
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2192
Country	:	US
Telephone Number	:	423-952-2111
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 MED TECH PKWY STE 300
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-2365
Country	:	US
Telephone Number	:	423-232-8301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2022
Last Update Date	:	02/11/2026

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Directions to “ MELANIE ANN MCAMIS ” Practice Location

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