MRS. AMANDA LYNN BRUSCHI (NPI# 1033179106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033179106 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA LYNN BRUSCHI |
| Other Name | MISS AMANDA LYNN CORDRAY |
| Credential | PA-C |
| Practice Address |
1616 S Kelly Ave Edmond OK 73013-3651 |
| Practice Telephone | 4053300015 |
| Practice Fax Number | 4053300092 |
| Mailing Telephone | 4053300015 |
| Mailing Fax Number | 4053300092 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2012-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1471 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200075020A | 05 |
| Street Address |
1616 S KELLY AVE |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881665347 | Donald E Adams | Physical Medicine & Rehabilitation | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2006-01-31 |
| 1336683515 | Madison Williams | Physician Assistant | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2016-12-07 |
| 1932515475 | Jeffrey Moore | Orthopaedic Surgery | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2014-07-04 |
| 1740694611 | Jenna Lynn Crowder | Family Medicine | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2014-06-18 |
| 1083952485 | Whitney T Mashburn | Physician Assistant | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2013-01-21 |
| 1205152600 | Hpi Physicians LLC | Internal Medicine | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2010-04-12 |
| 1891992996 | Laura Diane Petrash | Physician Assistant | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2007-07-02 |
| 1528097904 | Hillary Seth Lawrence | Dermatology | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2006-06-30 |
| 1578539029 | Rupert Rockwell Thomas Sr. | Obstetrics & Gynecology | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2006-02-24 |
| 1831164458 | Manuel Carl Limbaugh | Family Medicine | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2006-02-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861482887 | Eric J Campbell | Physician Assistant | 1701 S Renaissance Blvd, Suite 110, Edmond, OK 73013-3084 | 2005-10-21 |
| 1003092446 | Dinah Bess L'heureux | Physician Assistant | 1405 Nw 150th St, Edmond, OK 73013-1305 | 2008-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336779206 | John Nelson Lazenby IIi | Physician Assistant | 4 E Clark Bass Blvd Ste 302, Mcalester, OK 74501-4269 | 2020-01-20 |
| 1578025094 | Shawna Rose Liszewski | Physician Assistant | 6767 S Yale Ave Ste A, Tulsa, OK 74136-3302 | 2019-04-03 |
| 1417418666 | Andrea J Caygill | Physician Assistant | 216 N 20th St, Collinsville, OK 74021-1605 | 2019-03-29 |
| 1093290132 | Nisha Panta | Physician Assistant | 4120 W Memorial Rd # 300, Oklahoma City, OK 73120-9322 | 2018-09-25 |
| 1265920565 | Elite Surgical Assisting, LLC | Physician Assistant | 2924 S 98th East Ave, Tulsa, OK 74129-4407 | 2018-04-23 |
| 1417472259 | Brooke Javon Denton | Physician Assistant | 2924 S. 98th East Ave, Tulsa, OK 74129 | 2017-08-12 |
| 1104216662 | Morgan Hanni | Physician Assistant | 3520 Nw 20th St, Oklahoma City, OK 73107-2818 | 2015-02-04 |
| 1790103455 | A Cut Above Surgical Assisting LLC | Physician Assistant | 6313 E Commercial St, Broken Arrow, OK 74014-6981 | 2014-03-31 |
| 1518204056 | Dustin William Tims | Physician Assistant | 11317 S Western Ave Ste 300, Oklahoma City, OK 73170-5848 | 2013-01-03 |
| 1265797781 | Rebecca Lynn Painter | Physician Assistant | 9915 E 82nd Pl, Tulsa, OK 74133-4557 | 2012-07-10 |
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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.