Individual provider Active NPI

Amanda Marie Varghese, NP

  • Nurse Practitioner
  • Huntersville, NC
National Provider Identifier
1124538178
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009972 Issued in NC
Practice address
10030 Gilead Rd
Huntersville, NC 28078-7545
Phone
(704) 316-3789
Fax
(704) 316-6785
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009972 NC Primary

Addresses

Primary practice location

10030 Gilead Rd
Huntersville, NC 28078-7545

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-3789

Other practice location 1

433 McAlister Rd
FL 1
Lincolnton, NC 28092-4147
Phone (704) 512-5363

Other practice location 2

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 870-2654

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avarghese5053@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20171228000122 NC Practitioner - Nurse Practitioner 4789942558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

Hospital & facility affiliations

  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5009972NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 1, 2019 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 1, 2019 Accepting new patients

Locations

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

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 5

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1124538178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-3789",
            "fax_number": "704-316-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 GILEAD RD",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787545",
            "telephone_number": "704-316-3789",
            "fax_number": "704-316-6785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 McAlister Rd",
            "address_2": "FL 1",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924147",
            "country_code": "US",
            "telephone_number": "704-512-5363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Mocksville Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281442732",
            "country_code": "US",
            "telephone_number": "704-870-2654",
            "fax_number": "704-870-2655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avarghese5053@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "8800 N Tryon St",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282623300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.