Amanda Carroll Dickert, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 9325704 Issued in FL

Practice address

6199 W Gulf to Lake Hwy
Crystal River, FL 34429-2679

Phone

(352) 795-0644

NPI assigned

Apr 22, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1093135667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6199 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344292679",
            "telephone_number": "352-795-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6199 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344292679",
            "telephone_number": "352-795-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERT",
        "first_name": "AMANDA",
        "middle_name": "CARROLL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9325704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desaraju & Kompella, P.a. (Hospitalists Of Citrus County)
• Chakradhar Desaraju, MD
• Shanta Devaughn
• DH Pritchard MD PA (Crystal River Primary Care)
• Alex Jonathan Dickert, M.D.
• Jim C Dickert, DO
• Kaitlyn Dickert, PA-C
• Ryan Spencer Dickert, MD
• Mark Allen Dietrich, MA
• Virginia Dohn

• Family Nurse Practitioner in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.