Individual provider Active NPI

Amanda Conroy Naumann, CRNP

  • Pediatric Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1043372881
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP017102 Issued in PA
Practice address
1740 South St
Suite 200
Philadelphia, PA 19146-1514
Phone
(215) 735-5600
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 20163629 PA
Registered Dietitian 133V00000X
Pediatric Nurse Practitioner 363LP0200X SP017102 PA Primary

Addresses

Primary practice location

1740 South St
Suite 200
Philadelphia, PA 19146-1514

Mailing address

1740 South St
Suite 200
Philadelphia, PA 19146-1514
Phone (215) 735-5600

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20163629PAMDPediatric Nurse Practitioner
SP017102PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center City Pediatrics, LLC Current Accepting new patients

Locations

33 Rock Hill Rd
Ste 170
Bala Cynwyd, PA 19004

1740 South St
Ste 200
Philadelphia, PA 19146
Phone (215) 568-4080

2365 E York St
Philadelphia, PA 19125

Interoperability endpoints

  • Direct secure messaging: amandanaumann@ccpp.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1043372881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 SOUTH ST",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461514",
            "telephone_number": "215-735-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 SOUTH ST",
            "address_2": "SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461514",
            "telephone_number": "215-735-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUMANN",
        "first_name": "AMANDA",
        "middle_name": "CONROY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "20163629",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP017102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.