Individual provider Active NPI

Amanda D Marshburn, NP

  • Family Nurse Practitioner
  • Richlands, NC
National Provider Identifier
1003362765
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008952 Issued in NC
Practice address
8210 Richlands Hwy
Richlands, NC 28574-7198
Phone
(910) 324-7328
Fax
(910) 324-7329
NPI assigned
Aug 31, 2016
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201339 NC
Nurse Practitioner 363L00000X 5008952 NC
Family Nurse Practitioner 363LF0000X 5008952 NC Primary

Addresses

Primary practice location

8210 Richlands Hwy
Richlands, NC 28574-7198

Mailing address

701 Doctors Dr
Kinston, NC 28501-1589
Phone (252) 559-2200

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amarshburn273725@direct.vidanthealth.com
Direct Messaging Address amarshburn273725@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170124001197 NC Practitioner - Nurse Practitioner 5395027593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

701 Doctors Dr
Kinston, NC 28501-1584
Phone (252) 559-2200

8210 Richlands Hwy
Richlands, NC 28574-7198
Phone (910) 324-7328

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201339NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Mar 1, 2018 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

313 Airport Rd
Kinston, NC 28504
Phone (252) 559-2200

701 Doctors Dr
Kinston, NC 28501
Phone (252) 523-0687

701 Doctors Dr
Ste N
Kinston, NC 28501
Phone (252) 559-2200

8210 Richlands Hwy
Richlands, NC 28574
Phone (910) 324-7328

Interoperability endpoints

  • Direct secure messaging: amarshburn273725@direct.ecuhealth.com
  • Direct secure messaging: amarshburn273725@direct.vidanthealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1003362765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DOCTORS DR",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285011589",
            "telephone_number": "252-559-2200",
            "fax_number": "252-522-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 RICHLANDS HWY",
            "city": "RICHLANDS",
            "state": "NC",
            "postal_code": "285747198",
            "telephone_number": "910-324-7328",
            "fax_number": "910-324-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHBURN",
        "first_name": "AMANDA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "201339",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008952",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amarshburn273725@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amarshburn273725@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richlands, NC

Sources for this page

Verify at the official NPI Registry.