AMANDA MAYS LACK (NPI# 1124532528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124532528 |
| Entity Type | Individual |
| Full Name | AMANDA MAYS LACK |
| Credential | APRN |
| Practice Address |
108 Highway 28 Byp Anderson SC 29624-3742 |
| Practice Telephone | 8647728173 |
| Practice Fax Number | 8339961161 |
| Mailing Telephone | 8647728173 |
| Mailing Fax Number | 8339961161 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2020-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN162689 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
23238 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP6410 | 05 |
| Street Address |
108 HIGHWAY 28 BYP |
| City | ANDERSON |
| State | SC |
| Zip Code | 29624-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366459323 | Walgreen Co | Pharmacy | 108 Highway 28 Byp, Anderson, SC 29624-3742 | 2006-08-02 |
| 1538773122 | Heather Leanna Hembree | Pharmacist | 108 Highway 28 Byp, Anderson, SC 29624-3742 | 2020-09-01 |
| 1285287482 | Partners In Primary Care (nc), P.C. | Internal Medicine | 108 Highway 28 Byp, Anderson, SC 29624-3742 | 2019-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598281255 | Developmental Center for Exceptional Children | Physical Therapist | 1100 West Franklin Street, Anderson, SC 29624 | 2017-08-15 |
| 1700975364 | Edgar Leland Talbert | General Practice | 1028 South Main Street, Anderson, SC 29624 | 2006-10-12 |
| 1629181060 | Robert Glenn Austin | Dentist | 218-a East Shockley Ferry Rd, Anderson, SC 29624 | 2006-08-17 |
| 1184103178 | William Stephen Leonard | Pharmacist | 922 Highway 28 Byp, Anderson, SC 29624-1114 | 2018-08-09 |
| 1245260389 | Hrbacek Chiropractic | Chiropractor | 918 Hwy 28 By Pass, Anderson, SC 29624-1114 | 2006-07-04 |
| 1558327452 | Shannon Hatchell Farr | Chiropractor | 918 Highway 28 Byp, Anderson, SC 29624-1114 | 2006-04-21 |
| 1538434261 | Healthsource of Anderson-west | Chiropractor | 918 Highway 28 Byp, Anderson, SC 29624-1114 | 2012-03-13 |
| 1184639270 | Walgreen Co | Pharmacy | 2539 W Whitner St, Anderson, SC 29624-1146 | 2006-07-29 |
| 1730637968 | Joey Alexander Mink | Pharmacist | 2539 W Whitner St, Anderson, SC 29624-1146 | 2016-09-16 |
| 1225461700 | Lacie Tijerina | Pharmacist | 2539 W Whitner St, Anderson, SC 29624-1146 | 2013-08-19 |
| Find all providers in zip 29624 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750570156 | Tina Marie Baxter | Nurse Practitioner | 720 W 8th St, Anderson, IN 46016-1206 | 2007-10-22 |
| 1962420109 | Shelly Renae Sparks | Nurse Practitioner | 1210 Medical Arts Blvd Ste 117, Anderson, IN 46011-3461 | 2006-07-17 |
| 1184087629 | Daniel B Shepler | Nurse Practitioner | 2210 Jackson St, Anderson, IN 46016-4363 | 2016-04-01 |
| 1780046102 | Erika Mccarty | Nurse Practitioner | 100 Healthy Way, Suite 1120, Anderson, SC 29621-7915 | 2016-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043152 | Lorenzo Ford | Nurse Practitioner | 20 Pioneer Ct, Sumter, SC 29150-9559 | 2020-08-13 |
| 1407484041 | Vistina Metts Johnson | Nurse Practitioner | 121 Executive Center Dr Ste 131, Columbia, SC 29210-8492 | 2020-03-30 |
| 1154969012 | William R. Andrews | Nurse Practitioner | 1516 Old Trolley Rd Ste 101, Summerville, SC 29485-8345 | 2019-12-11 |
| 1265078570 | Paula Nicole Allen | Nurse Practitioner | 133 Beaver Dam Rd, Columbia, SC 29223-3101 | 2019-11-21 |
| 1306497557 | Dina Martin | Nurse Practitioner | 171 Monroe Ln, Lexington, SC 29072-3904 | 2019-09-27 |
| 1053801720 | Kristin Marie Scarborough | Nurse Practitioner | 1470 Tobias Gadson Blvd Ste 203, Charleston, SC 29407-4925 | 2018-05-17 |
| 1922511054 | Anne Louise Grogan-hanford | Nurse Practitioner | 1317 Quail Vly W, Columbia, SC 29212-1554 | 2017-11-11 |
| 1972941821 | Jeanne Cameron Gonzalez | Nurse Practitioner | 504 Huntington Rd, Greenville, SC 29615-4212 | 2013-06-12 |
| 1861676942 | Mary Ellen Sullivan | Nurse Practitioner | 304 E Market St, Agape Physicians Care, Bennettsville, SC 29512-3137 | 2007-12-25 |
| 1508839739 | Vanessa Thompson | Nurse Practitioner | 391 Serpentine Dr Ste 400, Spartanburg, SC 29303-3081 | 2006-02-08 |
| 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.