Active NPI
Amanda Marie Macdonnell, APN-C
- Family Nurse Practitioner
- Castle Rock, CO
National Provider Identifier
1104023803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5268
- Practice address
- 750 N Ridge Rd
Castle Rock, CO 80104-8950 - Phone
- (303) 658-9817
- NPI assigned
- Jun 27, 2007
- Last updated
- Feb 22, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5268 | CO | Primary |
Addresses
Primary practice location
750 N Ridge Rd
Castle Rock, CO 80104-8950
Mailing address
4761 S Flat Rock CT
Aurora, CO 80016-5833
Phone (303) 889-9996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5268 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Stop LLC | Past | Accepting new patients |
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": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1104023803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4761 S FLAT ROCK CT",
"city": "AURORA",
"state": "CO",
"postal_code": "800165833",
"telephone_number": "303-889-9996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 N RIDGE RD",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801048950",
"telephone_number": "303-658-9817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONNELL",
"first_name": "AMANDA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "APN-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-27",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "5268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castle Rock, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.