Amanda Puckett, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R232943 Issued in MD

Practice address

2720 Carsins Run Rd
Aberdeen, MD 21001-1516

Phone

(443) 356-1922

NPI assigned

Mar 22, 2023

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 MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Quince Orchard Psychotherapy LLCGroup PAC ID 5395194302, 30 clinicians

Serene Wellness Psychiatry LLCGroup PAC ID 9335587310, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Quince Orchard Psychotherapy LLC

  dba Orchard Mental Health Group

  • Psychiatry Physician
  • Rockville, MD
  • NPI 1336670389

  DC

  Medicare reassignment Care Compare group NPD
• Serene Wellness Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bel Air, MD
  • NPI 1528818820
  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Oasis the Mental Health Center, LLC

  dba Oasis Behavioral Health Urgent Care

  • Psychiatry Physician
  • Glen Burnie, MD
  • NPI 1174606057
  NPD (past)
• Quince Orchard Psychotherapy LLC

  • Clinical Social Worker
  • Nottingham, MD
  • NPI 1619895844
  NPD (past)

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1114629037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 CARSINS RUN RD",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210011516",
            "telephone_number": "443-356-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 CARSINS RUN RD",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210011516",
            "telephone_number": "443-356-1922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16A Bel Air South Pkwy Ste 321",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210156038",
            "country_code": "US",
            "telephone_number": "410-561-6207",
            "fax_number": "410-670-7393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R232943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Progressive Multi Medical Services Inc
• Progressive Multi Medical Services Inc (PMMS)
• Prohealth Primary Care LLC
• Prompt Occupational Healthcare LLC
• PS Programs, LLC
• Quality Mobile Lab
• Quality Nursing Agency LLC
• Jessica Lynn Raab, PT, DPT
• Alphonsa Abdul Rahman, DNP, APRN,CNS, CCRN
• Valerie Lynn Reed, O. D.

• Psychiatric/Mental Health Nurse Practitioner in Aberdeen, MD
• Providers in Aberdeen, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.