Individual provider Active NPI

Amanda Jo Phelps, NP

  • Women's Health Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1104101047
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
71003752A Issued in IN
Practice address
220 E Virginia St
Evansville, IN 47711-5530
Phone
(812) 777-0127
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 71003752A IN Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 71003752A IN

Addresses

Primary practice location

220 E Virginia St
Evansville, IN 47711-5530

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Other practice location 1

4199 Gateway Blvd Ste 3500
Newburgh, IN 47630-7909
Phone (812) 858-5950

Other identifiers 1

IdentifierTypeStateIssuer
20104470MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20111209000521 IN Practitioner - Nurse Practitioner 2163697772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Exceptional Medical Care 22 clinicians

Practice addresses (Care Compare)

4972 Lincoln Ave
Suite 101
Evansville, IN 47715-7909
Phone (812) 402-3700

Hospital & facility affiliations

  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319
  • The Women'S Hospital Hospital, Newburgh, IN, CCN 150149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71003752AINMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allure Wellness and Health Center LLC Women'S Health CurrentSince Apr 13, 2026 Accepting new patients
Indiana Exceptional Medical Care CurrentSince Aug 4, 2025 Accepting new patients
Amandaphelps-Jones LLC Women'S Health CurrentSince May 31, 2023 Accepting new patients
Major Hospital Past Accepting new patients

Locations

218 E Virginia St
Evansville, IN 47711

4972 Lincoln Ave
Ste 101
Evansville, IN 47715
Phone (812) 402-3700

220 E Virginia St
Evansville, IN 47711
Phone (812) 431-5983

4962 Lincoln Ave
Evansville, IN 47715
Phone (812) 402-3700

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1104101047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477115530",
            "telephone_number": "812-777-0127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4199 Gateway Blvd Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307909",
            "country_code": "US",
            "telephone_number": "812-858-5950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "71003752A",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IN",
            "license": "71003752A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20104470",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.