Active NPI
Amanda Jean Maddox, FNP
- Nurse Practitioner
- Summerdale, AL
National Provider Identifier
1073109708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1-150202
- Practice address
- 511 State Highway 59 N
Summerdale, AL 36580-3686 - Phone
- (251) 989-9400
- NPI assigned
- Dec 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1-150202 | AL | |
| Nurse Practitioner | 363L00000X | 1-150202 | AL | Primary |
Addresses
Primary practice location
511 State Highway 59 N
Summerdale, AL 36580-3686
Mailing address
PO Box 703
Summerdale, AL 36580-0703
Phone (251) 989-9400
Other practice location 1
6631 Park Dr
Daphne, AL 36526-5227
Phone (251) 626-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
226 Lakefront Cir
Summerdale, AL 36580-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1073109708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 703",
"city": "SUMMERDALE",
"state": "AL",
"postal_code": "365800703",
"telephone_number": "251-989-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 STATE HIGHWAY 59 N",
"city": "SUMMERDALE",
"state": "AL",
"postal_code": "365803686",
"telephone_number": "251-989-9400"
}
],
"practiceLocations": [
{
"address_1": "6631 Park Dr",
"address_purpose": "LOCATION",
"city": "Daphne",
"state": "AL",
"postal_code": "365265227",
"country_code": "US",
"telephone_number": "251-626-5700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MADDOX",
"first_name": "AMANDA",
"middle_name": "JEAN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-16",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "1-150202",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1-150202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerdale, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- 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.