Individual provider Active NPI

Amanda Ellen Berry, MSN, RN, ACNP

  • Acute Care Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1083651079
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN 141398 NP Issued in GA
Practice address
550 Peachtree St NE
Atlanta, GA 30308-2208
Phone
(404) 502-2787
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN 141398 NP GA Primary

Addresses

Primary practice location

550 Peachtree St NE
Atlanta, GA 30308-2208

Mailing address

2245 Fort St SE
Smyrna, GA 30080-9262
Phone (404) 502-2787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060815000142 GA Practitioner - Nurse Practitioner 6305849290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians

Practice addresses (Care Compare)

460 Northside Cherokee Blvd
Suite 150
Canton, GA 30115-8018
Phone (770) 924-5095

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
67.82
Promoting interoperability
77
Improvement activities
40
Cost
77.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 141398 NPGAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Cardiovascular Professional Services, LLC CurrentSince Jan 29, 2024 Accepting new patients

Locations

1110 W Peachtree St NW
Ste 920
Atlanta, GA 30309

460 Northside Cherokee Blvd
Ste 150
Canton, GA 30115
Phone (470) 639-6250

1285 Upper Hembree Rd
Roswell, GA 30076
Phone (770) 343-8565

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1083651079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 FORT ST SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300809262",
            "telephone_number": "404-502-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-502-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "AMANDA",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MSN, RN, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN 141398 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.