Individual provider Active NPI

Amanda Dancy Bundy, FNP-C

  • Family Nurse Practitioner
  • Jefferson, NC
National Provider Identifier
1063049963
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5013014 Issued in NC
Practice address
310 Hospital Avenue
Jefferson, NC 28643
Phone
(336) 846-6322
NPI assigned
Mar 23, 2020
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5013014 NC Primary

Addresses

Primary practice location

310 Hospital Avenue
Jefferson, NC 28643

Mailing address

150 Stanley Blevins Rd
Lansing, NC 28643-9194
Phone (336) 977-6520

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
I20210106001859 NC Practitioner - Nurse Practitioner 6507279858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashe Financial Services LLCGroup PAC ID 8729377692, 6 clinicians

Practice addresses (Care Compare)

200 Hospital Ave
Suite 3
Jefferson, NC 28640-9244
Phone (336) 846-7433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.52
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5013014NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashe Financial Services, LLC CurrentSince Feb 1, 2024 Accepting new patients
Ashe Financial Services, LLC CurrentSince Feb 1, 2024 Accepting new patients
Cardiology Physicians Corporation, LLC PastSince Mar 29, 2020 Accepting new patients

Locations

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

200 Hospital Ave
Ste 3
Jefferson, NC 28640
Phone (336) 846-7101

Interoperability endpoints

  • Direct secure messaging: amanda.bundy.1@14562.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1063049963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 STANLEY BLEVINS RD",
            "city": "LANSING",
            "state": "NC",
            "postal_code": "286439194",
            "telephone_number": "336-977-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HOSPITAL AVENUE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "28643",
            "telephone_number": "336-846-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDY",
        "first_name": "AMANDA",
        "middle_name": "DANCY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

Verify at the official NPI Registry.