MS. AMANDA BANCROFT BURRAGE (NPI# 1023452984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023452984 |
| Entity Type | Individual |
| Full Name | MS. AMANDA BANCROFT BURRAGE |
| Credential | M.D. M.P.H. |
| Practice Address |
167 Main St. Tuba City AZ 86045 |
| Practice Telephone | 8669765941 |
| Mailing Telephone | 6179219084 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2020-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 76475 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3181 Sw Sam Jackson Park Road, Ohsu, Portland, OR 97239 | 5034948211 |
| Street Address |
167 MAIN ST. |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902353774 | Steven Barrett | Physical Therapist | 167 Main St., Tuba City, AZ 86045 | 2016-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1659620375 | Healthy Nation Transport LLC | Non-emergency Medical Transport (VAN) | 4222 Cactus Loop Drive, Tuba City, AZ 86045 | 2012-09-10 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699018358 | Margaret Rose Ray | Pediatrics | 167 North Main Street, Tuba City, AZ 86045-0600 | 2013-04-01 |
| 1801113568 | Sara A Jager | Pediatrics | 167 N Main Street, Attn: Med Staff Office, Tuba City, AZ 86045-0600 | 2010-04-21 |
| 1407086721 | Catherine Ann Golski | Pediatrics | 167 N. Main Street, Tuba City Regional Health Care Corporation, Tuba City, AZ 86045 | 2009-07-21 |
| 1588698005 | William H Orman | Pediatrics | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-07-10 |
| 1255365763 | Stephen A Holve | Pediatrics | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-07-10 |
| 1750315339 | Steven W. Moul | Pediatrics | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-07-10 |
| 1598798647 | Diana Chi-hwa Hu | Pediatrics | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-07-09 |
| 1649211988 | Jane A Oski | Pediatrics | 167 North Main Street, Tuba City, AZ 86045-0600 | 2006-06-09 |
| 1366415846 | Miran Joelle Song | Pediatrics | 167 North Main Street, Tcrhcc, Tuba City, AZ 86045-0600 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689272700 | Pediatric Multicare West, LLC | Pediatrics | 316 W. White Mountain Blvd., Suite A, Lakeside, AZ 85929 | 2020-10-12 |
| 1629614466 | Kayla Leanne Cantu | Pediatrics | 15264 W Brookside Ln Ste 155, Surprise, AZ 85374-3997 | 2019-11-26 |
| 1306487350 | Roots Pediatric Therapy, LLC | Pediatrics | 7340 E Legacy Blvd Unit C2006, Scottsdale, AZ 85255-6388 | 2019-10-01 |
| 1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
| 1952965212 | Jeremey William Gneck | Pediatrics | 1625 N Campbell Ave Tucson Az 85719, Tucson, AZ 85724-0001 | 2019-04-23 |
| 1164985305 | Desert Sky Pediatrics | Pediatrics | 3301 N Miller Rd Ste 170, Scottsdale, AZ 85251-6421 | 2019-04-12 |
| 1780146829 | Jb Healthcare LLC | Pediatrics | 10575 W Indian School Rd Ste 103, Avondale, AZ 85392-5651 | 2019-04-05 |
| 1902370349 | Dwayne St. Jacques Md Pllc | Pediatrics | 15215 South 48th Street, Suite 110, Phoenix, AZ 85044-9375 | 2019-01-18 |
| 1245703966 | Pleasant Pediatrics Plc | Pediatrics | 15715 S 46th St Ste 102, Phoenix, AZ 85048-0439 | 2019-01-04 |
| 1992295158 | Melanie Anne Kaplanek | Pediatrics | 1501 N Campbell Ave Rm 3301, Tucson, AZ 85724-0001 | 2018-05-14 |
| Find all providers with the same taxonomy | ||||
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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.