Amanda Nicole Cleghorne, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN 218110 Issued in GA

Practice address

4355 Browns Bridge Rd Ste 1
Cumming, GA 30041-4554

Phone

(770) 771-5050

Fax

(770) 771-5051

NPI assigned

Jun 28, 2016

Sex

Female

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1104277474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 BROWNS BRIDGE RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300414554",
            "telephone_number": "770-771-5050",
            "fax_number": "770-771-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 BROWNS BRIDGE RD STE 1",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300414554",
            "telephone_number": "770-771-5050",
            "fax_number": "770-771-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEGHORNE",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN 218110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clearview Eye Care, Inc
• Cleaver Medical Group Dermatology Inc
• Cleaver Medical Group PC
• Cleaver Medical Group Surgery Center
• Nathan Jerome Cleaver, DO
• Cassandra J Cleland, PT
• Kaitlin Cleland, CRNA
• Clemons Physical Therapy, LLC
• Laura Anne Clemons, D.P.T
• Robin Clesen

• Primary Care Nurse Practitioner in Cumming, GA
• Providers in Cumming, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.