Amanda Iddins Harris, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN107544AP06096 Issued in LA

Practice address

10100 Goodwood Blvd
Baton Rouge, LA 70815-4521

Phone

(225) 924-7707

Fax

(225) 926-9467

NPI assigned

Mar 16, 2010

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

Other identifiers 2

Other names 1

• Mandy J. Iddins Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Health Care Centers in Schools

  dba HCS-Istrouma High School

  • Clinic/Center
  • Baton Rouge, LA
  • NPI 1467678045
  NPD (past)
• Our Lady of the Lake Physician Group LLC

  dba OLOL Physician Surgical Specialty

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455
  NPD (past)

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1114241460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54466",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701544466",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 GOODWOOD BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708154521",
            "telephone_number": "225-924-7707",
            "fax_number": "225-926-9467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3730 Winbourne Ave",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708055947",
            "country_code": "US",
            "telephone_number": "225-343-9505",
            "fax_number": "225-343-9141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "AMANDA",
        "middle_name": "IDDINS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-16",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN107544AP06096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00879558",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2113259",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "IDDINS",
            "middle_name": "J.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melodi Katrice Harris Allen
• Lacy Harris-Rowe
• A'Niaya Harris
• Adam Harris, MD
• Alyssa Nicole Harris, CRNA
• Angela Carolyn Harris, D.O.
• April Harris
• Arlishea L Harris, LCSW
• Benjamin B Harris
• Brittany Harris, PMHNP

• Family Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.