Provider Demographics
NPI:1821455080
Name:BELOTT, AMY NANCY JEAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:NANCY JEAN
Last Name:BELOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 HILL RD N
Mailing Address - Street 2:SUITE A
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9346
Mailing Address - Country:US
Mailing Address - Phone:614-833-0880
Mailing Address - Fax:614-833-6767
Practice Address - Street 1:495 COOPER RD STE 400
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8730
Practice Address - Country:US
Practice Address - Phone:614-865-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004560RX363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant