AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1013786219

AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) is a healthcare provider. based in Clarksville, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. They hold a License No. PA5867 (TN). The NPI Number for AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) is 1013786219

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT)
NPI
1013786219
Phone
(931) 502-3810
Address
647 DUNLOP LN STE 210
Enumeration Date
28 December 2023
Last Update Date
22 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9315025080
Graduation Year
2023 (3 years ago)
PAC ID
3274971858
Group Practice PAC ID
0547276917
Professional Enrollment ID
I20240402000494
Address ID
TN370405015CL651XXLNXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,134 PHYSICIAN ASSISTANT in TN

Provider Addresses for AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT)

  • 647 DUNLOP LN STE 210

    CLARKSVILLE, TN 370405165

    Phone: (931) 502-3810

    Fax: (931) 502-2512

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 107 Open Payments records for all available years, with a total value of $2,218.

Total Amount is formed as General ($2,218) + Research ($0) + Ownership ($0) = $2,218.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($962).

Total Amount

$2,218

General + Research + Ownership

Payments

107

Total payment records

General Amount

$2,218

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-02

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240402000494IPhysician AssistantTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37040)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547276917View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YTN
General SurgeryGA
General SurgeryPA
Nurse PractitionerTN
Vascular Surgery, General SurgeryTN
Physician AssistantTN
General SurgeryTN
-TN
Nurse PractitionerTN
Internal MedicineTN

Reviews

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Frequently asked questions

Is AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) listed with a National Provider Identifier?
Yes — AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) has NPI 1013786219 on file in the registry.
Is AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) shown as active in public data?
Registry records indicate AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) maintains an active NPI.
How would a patient describe AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT)'s focus?
For AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Tennessee is AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) registered?
Use Clarksville, Tennessee as the headline location for AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) here.
When was this NPI issued?
Enumeration for AMANDA MARIA BAHNAM (PHYSICIAN ASSISTANT) is noted as December 28, 2023 where the registry provides it.

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