Amanda Skvortsov, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

221063 Issued in OK

Practice address

109 W Commercial St
Broken Arrow, OK 74012-4012

Phone

(918) 887-8300

NPI assigned

Nov 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: amanda.skvortsov.1@24551.direct.athenahealth.com

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1063238665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31193 E 64TH ST S",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740148529",
            "telephone_number": "941-350-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W COMMERCIAL ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124012",
            "telephone_number": "918-887-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKVORTSOV",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "221063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kattie Ellen Sisco, PHARMD
• Dianne Sitz
• Jenifer Renee Skeans, CSFA
• Clarence Skipper III
• Zoe Skorodin, SLP
• Skye Horizon Mental Health LLC
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• Small Group Anesthesia Services, LLC
• Kimberly A Smallwood, APRN
• Alexis Smith

• Family Nurse Practitioner in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.