Individual provider Active NPI

Amanda Monroe, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Thomas, KY
National Provider Identifier
1083439145
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4030918 Issued in KY
Practice address
112 Sheridan Avenue
Back House
Fort Thomas, KY 41075
Phone
(859) 638-2480
NPI assigned
Nov 22, 2024
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4030918 KY Primary

Addresses

Primary practice location

112 Sheridan Avenue
Back House
Fort Thomas, KY 41075

Mailing address

112 Sheridan Avenue
Back House
Fort Thomas, KY 41075
Phone (859) 638-2480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, KS2 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

Enrollment IDStateProvider typePAC IDDetails
I20250307001242 IA Practitioner - Nurse Practitioner 1658892534 Reassigns benefits to 1 organization
I20250325000859 KS Practitioner - Nurse Practitioner 1658892534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bliss Psychiatry, LLCGroup PAC ID 3476940024, 4 clinicians

Practice addresses (Care Compare)

699 Walnut St
Suite 400
Des Moines, IA 50309-3962
Phone (515) 441-7944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4030918KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bliss Psychiatry, LLC CurrentSince Feb 13, 2025 Accepting new patients

Locations

699 Walnut St
Ste 400
Des Moines, IA 50309
Phone (515) 441-7944

8101 College Blvd
Ste 100
Overland Park, KS 66210
Phone (877) 644-6669

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1083439145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SHERIDAN AVENUE",
            "address_2": "BACK HOUSE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "41075",
            "telephone_number": "859-638-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SHERIDAN AVENUE",
            "address_2": "BACK HOUSE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "41075",
            "telephone_number": "859-638-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "AMANDA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4030918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

Verify at the official NPI Registry.