NPIMap

Individual provider Active NPI

Amanda Igata, FNP

  • Family Nurse Practitioner
  • South Boston, VA
National Provider Identifier
1063844926
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024171074 Issued in VA
Practice address
101 Aubreys Loop
South Boston, VA 24592-5056
Phone
(434) 517-3879
NPI assigned
Aug 2, 2013
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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 0024171074 VA Primary

Addresses

Primary practice location

101 Aubreys Loop
South Boston, VA 24592-5056

Mailing address

101 Aubreys Loop
South Boston, VA 24592-5056
Phone (434) 517-3879

Other practice location 1

21054A Timberlake Rd
Lynchburg, VA 24502-7327
Phone (434) 239-0627

Other identifiers 1

IdentifierTypeStateIssuer
0024171074OtherVAVA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131011001173 VA Practitioner - Nurse Practitioner 5193959872 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Igata and Parke PLCGroup PAC ID 9234671744, 2 clinicians

Practice addresses (Care Compare)

14805 Forest Rd
Suite 229
Forest, VA 24551-5019
Phone (434) 207-2337

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024171074VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Virginia Current Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince May 16, 2015 Accepting new patients
Dominion Health Medical Assoc. Current Accepting new patients
Dominion Health Medical Assoc CurrentSince Aug 26, 2013 Accepting new patients
Igata and Parke PLC CurrentSince May 1, 2024 Accepting new patients
Dominion Health Medical Assoc CurrentSince Aug 26, 2013 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince May 16, 2015 Accepting new patients

Locations

946 N Main St
Chase City, VA 23924
Phone (434) 372-5141

115 College St
Clarksville, VA 23927
Phone (434) 374-5344

14805 Forest Rd
Ste 229
Forest, VA 24551
Phone (434) 207-2337

21054A Timberlake Rd
Lynchburg, VA 24502
Phone (434) 239-0627

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

101 Aubreys Loop
South Boston, VA 24592
Phone (434) 517-3879

2232 Wilborn Ave
Ste F
South Boston, VA 24592
Phone (434) 517-8095

Interoperability endpoints

  • Direct secure messaging: amanda.igata.1@31717.direct.athenahealth.com

Organizations & group practices 7

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 7

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": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1063844926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AUBREYS LOOP",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925056",
            "telephone_number": "434-517-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AUBREYS LOOP",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925056",
            "telephone_number": "434-517-3879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21054A Timberlake Rd",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245027327",
            "country_code": "US",
            "telephone_number": "434-239-0627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IGATA",
        "first_name": "AMANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENSE",
            "identifier": "0024171074",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.