| Amanda Michelle Outly, PA | |
|
61 Whitcher St Ne Ste 3110, Marietta, GA 30060-1179 | |
| (770) 422-2326 | |
| (770) 422-7231 |
| Full Name | Amanda Michelle Outly |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 2 Years |
| Location | 61 Whitcher St Ne Ste 3110, Marietta, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003298969 | NPI | - | NPPES |
| N3KG2 | Other | FL | BCBSFL |
| 022418500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 13002 (Georgia) | Primary |
| 363A00000X | Physician Assistant | PA9110768 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wellstar Kennestone Regional Medical Center | Marietta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 3059 |
| Entity Name | Wellstar Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Michelle Outly, PA 61 Whitcher St Ne Ste 3110, Marietta, GA 30060-1179 Ph: (770) 422-2326 | Amanda Michelle Outly, PA 61 Whitcher St Ne Ste 3110, Marietta, GA 30060-1179 Ph: (770) 422-2326 |
Mrs. Torey Charlise Davis-bogan, SA-C, CST Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3105 Rome Ct Sw, Marietta, GA 30064 Phone: 317-664-0771 |
Yumei Manzano, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 699 Church St Ne Ste 340, Marietta, GA 30060 Phone: 678-355-1620 |
Samantha Lee Chaparro, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1121 Johnson Ferry Rd Ste 310, Marietta, GA 30068 Phone: 770-675-9521 |
Jennifer Grimm, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060 Phone: 770-402-6438 |
Mrs. Lisa M Lewis, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4800 Olde Towne Pkwy Ste 250, Marietta, GA 30068 Phone: 770-971-3376 |
Ms. Megan Nichole Dalton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 340 Kennestone Hospital Blvd Ste 100, Marietta, GA 30060 Phone: 770-281-5100 Fax: 678-581-7100 |
Jonathan Collier Stone, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1044 Azalea Cir, Marietta, GA 30062 Phone: 770-354-0584 |