Active NPI
Amanda B Imming, CRNP
- Nurse Practitioner
- Dothan, AL
National Provider Identifier
1013986215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1102096
- Practice address
- 1901 Melba Drive
Dothan, AL 36301 - Phone
- (334) 794-6611
- Fax
- (334) 794-6614
- NPI assigned
- Mar 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1102096 | AL | Primary |
Addresses
Primary practice location
1901 Melba Drive
Dothan, AL 36301
Mailing address
1901 Melba Drive
Dothan, AL 36301
Phone (334) 794-6611
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51526538 | Other | AL | BLUE CROSS AND BLUE SHIEL |
| P00210640 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1102096 | AL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1013986215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 MELBA DRIVE",
"city": "DOTHAN",
"state": "AL",
"postal_code": "36301",
"telephone_number": "334-794-6611",
"fax_number": "334-794-6614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 MELBA DRIVE",
"city": "DOTHAN",
"state": "AL",
"postal_code": "36301",
"telephone_number": "334-794-6611",
"fax_number": "334-794-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMING",
"first_name": "AMANDA",
"middle_name": "B",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1102096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIEL",
"identifier": "51526538",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00210640",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dothan, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.