Amanda Jo Cordero, CRNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-147493 Issued in AL

Practice address

4245 Balmoral Dr SW Ste 102
Huntsville, AL 35801-6456

Phone

(256) 882-6555

NPI assigned

Apr 24, 2018

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 TN

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

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.

• Physicians Medical Care

  • Health Service Clinic/Center
  • Murfreesboro, TN
  • NPI 1588851661
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment NPD

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1013405133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 BALMORAL DR SW STE 102",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016456",
            "telephone_number": "256-882-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 BALMORAL DR SW STE 102",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016456",
            "telephone_number": "256-882-6555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2893 Huntsville Hwy",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "TN",
            "postal_code": "373346681",
            "country_code": "US",
            "telephone_number": "931-297-5028",
            "fax_number": "931-433-3068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24205",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-147493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIRECT PRIMARY CARE CLINIC",
            "identifier": "1-147493",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Clayton Coppage, LICSW-S
• Eurdis Coppedge-Walker
• Mary Mason Corbett
• Hayley Corder, SLP
• Kellie Anne Corder, PA-C
• Emily Cork, CRNP
• Luther Franklin Corley III, M.D.
• Lourdes Carlotta Corman, MD
• Cornelia K Turnbow LLC
• Kathy Camille Cornelius, MD

• Family Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.