Amanda Lee Groome, AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

19644 Issued in SC

Practice address

255 Enterprise Blvd
Suite 101
Greenville, SC 29615-6300

Phone

(864) 454-8120

Fax

(864) 454-8125

NPI assigned

Oct 27, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Itrust Wellness GroupGroup PAC ID 0648532028, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Itrust Wellness Group

  • Psychiatry Physician
  • Greenville, SC
  • NPI 1629517222
  Medicare reassignment Care Compare group NPD
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD
• PH Health Care Services Inc

  • Community Based Hospice Care Agency
  • Easley, SC
  • NPI 1134491616
  NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Itrust Cares LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenville, SC
  • NPI 1225751068
  NPD (past)

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1013217850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 ENTERPRISE BLVD",
            "address_2": "SUITE 101",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156300",
            "telephone_number": "864-454-8120",
            "fax_number": "864-454-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOME",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "19644",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "19644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3381",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan J Grnak, DO
• Tonjia Groblewski, M. ED.
• Tywana Groce, D.M.D.
• Cameron Groen, LMFT
• Pearson Groom
• Samuel J Groot, MD
• Caroline Gross
• Virginia Gross, MA LPC/I
• Grove Medical Inc
• Daniel Austin Grover, MD

• Primary Care Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Primary Care Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.