Amanda Jevahirian, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704300662 Issued in MI

Practice address

25650 Outer Dr
Lincoln Park, MI 48146-2096

Phone

(313) 383-1897

Fax

(313) 383-6018

NPI assigned

Jul 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Amanda Reed Former name

Medicare fee-for-service enrollment

Enrolled in MI

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promed Preferred Mi 3, PLLCGroup PAC ID 3971012832, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holistic Home Healthcare, LLC Home health agency, Garden City, MI, CCN 239333
• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.reed.1@17288.direct.athenahealth.com

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.

• Promed Preferred Mi 3, PLLC

  • Internal Medicine Physician
  • Garden City, MI
  • NPI 1467258095
  Medicare reassignment Care Compare group NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Inkster, MI
  • NPI 1972530277
  Medicare reassignment NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Ecorse, MI
  • NPI 1316510860
  NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Dearborn, MI
  • NPI 1649820986
  NPD
• Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Lincoln Park, MI
  • NPI 1508280116
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holistic Home Healthcare LLC

  • Home Health Agency
  • Garden City, MI
  • NPI 1023586237
  Care Compare affiliation
• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1063185072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SCHAEFER RD STE 340",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263743",
            "telephone_number": "313-561-5100",
            "fax_number": "313-565-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25650 OUTER DR",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462096",
            "telephone_number": "313-383-1897",
            "fax_number": "313-383-6018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Hamlin Blvd",
            "address_purpose": "LOCATION",
            "city": "Inkster",
            "state": "MI",
            "postal_code": "481412206",
            "country_code": "US",
            "telephone_number": "313-383-1897",
            "fax_number": "313-383-6018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26650 Eureka Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Taylor",
            "state": "MI",
            "postal_code": "481804835",
            "country_code": "US",
            "telephone_number": "734-941-4991",
            "fax_number": "734-941-4919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Schaefer Rd Ste 255",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481263655",
            "country_code": "US",
            "telephone_number": "313-561-5100",
            "fax_number": "313-565-0309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEVAHIRIAN",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704300662NSA210LV",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704300662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "REED",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Irene D Ivanac, LLMSW
• Michael A Izzo, D.D.S.
• J & P Quality Home Care Services
• Gabrielle S Jackson, MA
• Tyler Jackson, LLMSW
• Jalen Johnson
• Marway Sharon Johnson, LMSW
• Mindi Lynne Johnson, DNP, RN, AGCNS-BC
• Zenique M Johnson
• Tange Jones-Berry

• Family Nurse Practitioner in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.