Individual provider Active NPI

Amanda Deann Williamson, APRN-CNP

  • Family Nurse Practitioner
  • Slaton, TX
National Provider Identifier
1124626940
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1013660 Issued in TX
Practice address
12309 FM 3431
Slaton, TX 79364-1207
Phone
(806) 786-2716
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1013660 TX Primary

Addresses

Primary practice location

12309 FM 3431
Slaton, TX 79364-1207

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Other practice location 1

1910 Quaker Ave Ste 101
Lubbock, TX 79407-2433
Phone (806) 725-4440

Other practice location 2

5202 82nd St
Lubbock, TX 79424-2823
Phone (806) 725-7337

Other practice location 3

611 N Frankford Ave
Lubbock, TX 79416-1545
Phone (806) 725-5480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211117002730 TX Practitioner - Nurse Practitioner 4880083518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians UnityGroup PAC ID 6406014919, 61 clinicians

Practice addresses (Care Compare)

5406 Colgate St
Lubbock, TX 79416-3205
Phone (806) 507-3500

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
  • Continuecare Hospital at Medical Center Odessa Long-term care hospital, Odessa, TX, CCN 452121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1013660TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Unity Family Medicine CurrentSince Mar 17, 2023 Accepting new patients

Locations

5406 Colgate St
Lubbock, TX 79416
Phone (806) 507-3500

5224 75th St
Ste D
Lubbock, TX 79424
Phone (806) 791-0042

Interoperability endpoints

  • Direct secure messaging: awilliamson1995034@oc.providencedirect.org

Organizations & group practices 1

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 2

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1124626940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12309 FM 3431",
            "city": "SLATON",
            "state": "TX",
            "postal_code": "793641207",
            "telephone_number": "806-786-2716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 Quaker Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794072433",
            "country_code": "US",
            "telephone_number": "806-725-4440",
            "fax_number": "806-725-4441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5202 82nd St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794242823",
            "country_code": "US",
            "telephone_number": "806-725-7337",
            "fax_number": "806-723-7002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "611 N Frankford Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794161545",
            "country_code": "US",
            "telephone_number": "806-725-5480",
            "fax_number": "806-723-6156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "AMANDA",
        "middle_name": "DEANN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1013660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slaton, TX

Sources for this page

Verify at the official NPI Registry.