Individual provider Active NPI

Amanda Ann Farrell, APRN

  • Nurse Practitioner
  • Lake Geneva, WI
National Provider Identifier
1124451414
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7219-33 Issued in WI
Practice address
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone
(262) 245-4990
Fax
(262) 245-2248
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7219-33 WI Primary
Registered Nurse 163W00000X 194211-30 WI

Addresses

Primary practice location

N2950 State Road 67
Lake Geneva, WI 53147-2655

Mailing address

N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-4990

Other names 1

  • Amanda A Joyce Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20170322001427 WI Practitioner - Nurse Practitioner 1557646155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians

Practice addresses (Care Compare)

N2950 State Rd
Suite 67
Lake Geneva, WI 53147-2655
Phone (262) 245-0535

Hospital & facility affiliations

  • Mercyhealth at Home Home health agency, Janesville, WI, CCN 527018
  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
  • Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
194211-30WIMDRegistered Nurse
7219-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Mar 20, 2017 Accepting new patients
Mercy Health System Corporation CurrentSince Mar 20, 2017 Accepting new patients
Mercy Health System Corporation Current Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

350 Peller Rd
Lake Geneva, WI 53147
Phone (262) 245-0221

Interoperability endpoints

  • Direct secure messaging: afarrell24852@direct.mhemail.org

Organizations & group practices 3

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1124451414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-4990",
            "fax_number": "262-245-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2950 STATE ROAD 67",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472655",
            "telephone_number": "262-245-4990",
            "fax_number": "262-245-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "AMANDA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7219-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "194211-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "JOYCE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Geneva, WI

Sources for this page

Verify at the official NPI Registry.