Amanda Gildersleeve, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

202210764NP-PP Issued in OR

Practice address

1095 N 1St Ave
Stayton, OR 97383-1203

Phone

(503) 767-3226

NPI assigned

Jul 21, 2022

Last updated

Jul 21, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OR

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canyon Family Health IncGroup PAC ID 7416297973, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santiam Hospital & Clinics Hospital, Stayton, OR, CCN 380056

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andie.gildersleeve.1@19037.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canyon Family Health Inc

  • Primary Care Nurse Practitioner
  • Stayton, OR
  • NPI 1801386677
  Medicare reassignment Care Compare group NPD
• Santiam Memorial Hospital

  dba Santiam Health & Wellness Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stayton, OR
  • NPI 1801787171
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Care Compare affiliation
• Santiam Memorial Hospital

  • Ambulance
  • Stayton, OR
  • NPI 1962566752

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114652369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PINE ST SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973214628",
            "telephone_number": "971-246-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 N 1ST AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831203",
            "telephone_number": "503-767-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDERSLEEVE",
        "first_name": "AMANDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202210764NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Fu, RD, LDN
• Yasuyuki Fukuto, DMD
• Scott Demar Gale
• Gathered & Wise LLC
• Mary Margaret Gescher
• Fred Frank Girod, DMD
• Allison Leach Gladney, CLC
• Amelia Glazier, MD
• Daniel Godinez, PT, DPT
• Daren Lane Goin

• Family Nurse Practitioner in Stayton, OR
• Providers in Stayton, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.