AMANDA SUSON BLAIR, D.P.T, — NPI 1295986388 (Licensed & Credentialed Military Health Care Provider in MARSHALL, AR)

CMS-1500 Box 24J / 33a • NPI

1295986388

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171000000X

Licensed & Credentialed Military Health Care Provider

Box 32 Service Location & ZIP+4

1458 HENSLEY FARM RD, MARSHALL, AR, 72650-8672

✓ 9-Digit EDI 837 ZIP+4 (72650-8672)

Practice Phone & Referral Fax

(870) 448-6232

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1295986388 (AMANDA SUSON BLAIR, D.P.T,) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1295986388` (NPI-1 Individual Practitioner)
Provider / Legal Name	AMANDA SUSON BLAIR, D.P.T,
Plain-English Specialty	Licensed & Credentialed Military Health Care Provider NUCC Code: `171000000X` (Military Health Care Provider)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1458 HENSLEY FARM RD, MARSHALL, AR, 72650-8672
Practice Telephone / Fax	Tel: (870) 448-6232
Administrative Mailing Address	1458 HENSLEY FARM RD, MARSHALL, AR, 72650-8672
Enumeration & Last Sync	Enumerated: 2008-10-07 \| CMS Record Updated: 2008-10-07

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1458 HENSLEY FARM RD, MARSHALL, AR, 72650-8672

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Plain-English Taxonomy & CMS Crosswalk (171000000X)

What Does Taxonomy Code 171000000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171000000X translates to:
"Licensed & Credentialed Military Health Care Provider"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Military Health Care Provider for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AMANDA SUSON BLAIR, D.P.T,)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171000000X` — Military Health Care Provider Plain English: Licensed & Credentialed Military Health Care Provider	State: AR \| License: `PT 3102` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AMANDA SUSON BLAIR, D.P.T, (NPI #1295986388)