MEDICARE: DR. AMANDA SALANITRO MIXON M.D.

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	208M00000X	Hospitalist Physician	MD46243	TN
2	207R00000X	Internal Medicine Physician	MD46243	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051541909	OTHER	AL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	051541925	OTHER	AL	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417071309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA SALANITRO MIXON M.D.

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:	615-322-5048

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-5100
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:	615-936-0605

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

Provider Enumeration Date	:	03/18/2007
Last Update Date	:	12/17/2025

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Directions to “ DR. AMANDA SALANITRO MIXON M.D.” Practice Location

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