Individual provider Active NPI

Amanda Lee Keenan, CRNP

  • Family Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1124798053
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022593 Issued in PA
Practice address
720 Norman Dr
Lebanon, PA 17042-7481
Phone
(717) 639-3230
Fax
(717) 274-1659
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP022593 PA Primary
Registered Nurse 163W00000X RN660162 PA
Family Nurse Practitioner 363LF0000X MK7819088 PA

Addresses

Primary practice location

720 Norman Dr
Lebanon, PA 17042-7481

Mailing address

8100 Lancaster Ave
Bethel, PA 19507-9707
Phone (717) 851-1405

Other practice location 1

101 W Airport Rd # A
Lititz, PA 17543-9274
Phone (717) 466-2445

Other practice location 2

9 Nathan Ln # A
Annville, PA 17003-6500
Phone (717) 639-3350

Other practice location 3

954 Isabel Dr
Lebanon, PA 17042-7482
Phone (717) 376-1180

Other practice location 4

4150 Barrett Blvd
Ephrata, PA 17522-8979
Phone (717) 738-5648

Other practice location 5

600 Isabel Dr Ste 3
Lebanon, PA 17042-3500
Phone (717) 272-7272

Other practice location 6

6 Perri Ave
Myerstown, PA 17067-3200
Phone (717) 949-6581

Other practice location 7

30 N 4th St
Lebanon, PA 17046-5606
Phone (717) 274-0474

Other practice location 8

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 270-7688

Other practice location 9

101 Fairview Cir
Lebanon, PA 17042-9581
Phone (717) 279-7303

Other practice location 10

446 N Reading Rd Fl 2
Ephrata, PA 17522-9802
Phone (717) 738-5275

Other names 1

  • Amanda Heberling Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20221102000926 PA Practitioner - Nurse Practitioner 0345617429 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Mountain Regenerative Medicine PLLCGroup PAC ID 3779968367, 3 clinicians

Practice addresses (Care Compare)

124 E Main St
Fredericksburg, PA 17026-9528
Phone (717) 865-6183

Hospital & facility affiliations

  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225
  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN660162PAMDRegistered Nurse
SP022593PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Mountain Regenerative Medicine PLLC CurrentSince Aug 28, 2025 Accepting new patients
Lebanon Pain Relief Center PC CurrentSince Sep 1, 2025 Accepting new patients
The Good Samaritan Hospital of Lebanon, Pennsylvania CurrentSince Mar 13, 2024 Accepting new patients

Locations

1840 Quentin Rd
Lebanon, PA 17042
Phone (717) 272-0007

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

600 Isabel Dr
Ste 3
Lebanon, PA 17042
Phone (717) 272-7272

30 N 4th St
Lebanon, PA 17046
Phone (717) 270-1949

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCHDDD/Endpoint/CCHDDD

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 7

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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1124798053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 LANCASTER AVE",
            "city": "BETHEL",
            "state": "PA",
            "postal_code": "195079707",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 NORMAN DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427481",
            "telephone_number": "717-639-3230",
            "fax_number": "717-274-1659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Airport Rd # A",
            "address_purpose": "LOCATION",
            "city": "Lititz",
            "state": "PA",
            "postal_code": "175439274",
            "country_code": "US",
            "telephone_number": "717-466-2445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9 Nathan Ln # A",
            "address_purpose": "LOCATION",
            "city": "Annville",
            "state": "PA",
            "postal_code": "170036500",
            "country_code": "US",
            "telephone_number": "717-639-3350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "954 Isabel Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427482",
            "country_code": "US",
            "telephone_number": "717-376-1180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4150 Barrett Blvd",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175228979",
            "country_code": "US",
            "telephone_number": "717-738-5648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Isabel Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170423500",
            "country_code": "US",
            "telephone_number": "717-272-7272",
            "fax_number": "717-272-0072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Perri Ave",
            "address_purpose": "LOCATION",
            "city": "Myerstown",
            "state": "PA",
            "postal_code": "170673200",
            "country_code": "US",
            "telephone_number": "717-949-6581",
            "fax_number": "717-949-2816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170465606",
            "country_code": "US",
            "telephone_number": "717-274-0474",
            "fax_number": "717-270-2374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-270-7688",
            "fax_number": "717-270-3790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Fairview Cir",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170429581",
            "country_code": "US",
            "telephone_number": "717-279-7303",
            "fax_number": "717-279-7471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "446 N Reading Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175229802",
            "country_code": "US",
            "telephone_number": "717-738-5275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022593",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN660162",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "MK7819088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HEBERLING",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.