Individual provider Active NPI

Amanda Ellen Franklin, FNP-C

  • Family Nurse Practitioner
  • Vincennes, IN
National Provider Identifier
1104124163
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003554A Issued in IN
Practice address
528 N 1St St
Vincennes, IN 47591-1402
Phone
(812) 882-4434
Fax
(812) 885-6318
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003554A IN Primary

Addresses

Primary practice location

528 N 1St St
Vincennes, IN 47591-1402

Mailing address

528 N 1St St
Vincennes, IN 47591-1402
Phone (812) 882-4434

Other identifiers 2

IdentifierTypeStateIssuer
783687OtherINANTHEM
201012590MedicaidIN

Other names 1

  • Amanda E Horst Former name

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
I20110318000339 IN Practitioner - Nurse Practitioner 1759564438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

406 N 1St St
Vincennes, IN 47591-1340
Phone (812) 882-1106

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71003554AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Physician Services, Inc CurrentSince Jun 30, 2014 Accepting new patients
Good Samaritan Hospital CurrentSince Jun 30, 2014 Accepting new patients
Good Samaritan Hospital Physician Services Inc. Past Accepting new patients
Roundhouse Emergency Physicians LLC PastSince Sep 15, 2019 Accepting new patients

Locations

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

406 N 1st St
Vincennes, IN 47591
Phone (812) 882-1106

528 N 1st St
Vincennes, IN 47591
Phone (812) 882-4434

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

615 Dubois St
Vincennes, IN 47591
Phone (812) 885-8010

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Interoperability endpoints

  • Direct secure messaging: ahorst120943@direct.deaconess.com

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 2

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": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1104124163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911402",
            "telephone_number": "812-882-4434",
            "fax_number": "812-885-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911402",
            "telephone_number": "812-882-4434",
            "fax_number": "812-885-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKLIN",
        "first_name": "AMANDA",
        "middle_name": "ELLEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003554A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "783687",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201012590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HORST",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.