Amanda Nicola Jackson Woodall, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

197904 Issued in TN

Practice address

8130 Country Village Dr Ste 102
Cordova, TN 38016-2087

Phone

(901) 308-2915

Fax

(901) 308-2924

NPI assigned

Aug 9, 2018

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

Enrolled in MS, TN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jim Pang MD PLLCGroup PAC ID 4688925696, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awoodall23024@mlh.direct-ci.com
• Direct secure messaging: amanda.woodall.1@32437.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.

• Jim Pang MD PLLC

  • Clinic/Center
  • Cordova, TN
  • NPI 1447620901

  MS

  Medicare reassignment Care Compare group NPD
• Forefront Telecare Inc

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1174035612

  MS

  Medicare reassignment NPD
• Forefront-Rosenzweig Medical Services Professional Corporation

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1588101745

  TN

  Medicare reassignment NPD
• Healthquest PC

  • Psychiatry Physician
  • Cordova, TN
  • NPI 1548229131

  MS

  Medicare reassignment
• Vanderbilt University

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1285659706
  NPD (past)

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

• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1073092185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 TIMBER CREEK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184233",
            "telephone_number": "901-566-1002",
            "fax_number": "901-566-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 COUNTRY VILLAGE DR STE 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162087",
            "telephone_number": "901-308-2915",
            "fax_number": "901-308-2924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6857 Cobblestone Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386729312",
            "country_code": "US",
            "telephone_number": "662-253-8040",
            "fax_number": "662-470-5984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "AMANDA",
        "middle_name": "NICOLA JACKSON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "197904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Chinn Wodowski, PHARM. D
• Wolf River Dental Center PLLC
• Caneshia Wolobah, LMSW
• Catherine Robilio Womack, MD
• Amanda Murray Wood, R.D.
• George R Woodbury
• Mario Wooden Sr.
• Jerrie Woodland
• Alexes Woods
• Kelsey Woods

• Psychiatric/Mental Health Nurse Practitioner in Cordova, TN
• Providers in Cordova, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.