Individual provider Active NPI

Amanda Rose Correia, DO

  • Emergency Medicine Physician
  • Lebanon, NH
National Provider Identifier
1114487006
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
24848 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-4642
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 032.0134173 VT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 032.0134173 VT
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 24848 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

PO Box 810
Hanover, NH 03755-0810

Other practice location 1

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240625004132 VT Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 8224460191 Reassigns benefits to 1 organization
I20241219003787 NH Practitioner - Emergency Medicine 8224460191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Hospital & facility affiliations

  • Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
032.0134173VTMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Dec 17, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Dec 17, 2024 Accepting new patients
Rutland Hospital, Inc. CurrentSince Aug 5, 2024 Accepting new patients
Rutland Hospital, Inc. CurrentSince Aug 5, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic Emergency Medicine CurrentSince Dec 17, 2024 Accepting new patients
Rutland Hospital, Inc. Past Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

1 Medical Dr
Ofc
Lebanon, NH 03756

160 Allen St
Rutland, VT 05701

Organizations & group practices 7

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 3

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1114487006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-4642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Allen St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014560",
            "country_code": "US",
            "telephone_number": "802-775-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREIA",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "032.0134173",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VT",
            "license": "032.0134173",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "24848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.