Individual provider Active NPI

Amanda M Bailey, CRNP

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1144372541
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R131979 Issued in MD
Practice address
63 Thomas Johnson Dr
Frederick, MD 21702-4384
Phone
(301) 694-7600
Fax
(301) 228-2500
NPI assigned
Jan 17, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 R131979 MD Primary

Addresses

Primary practice location

63 Thomas Johnson Dr
Frederick, MD 21702-4384

Mailing address

610 Solarex Court
Frederick, MD 21703

Other identifiers 1

IdentifierTypeStateIssuer
N51966OtherMDCDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111114000534 MD Practitioner - Nurse Practitioner 7618141466 Reassigns benefits to 1 organization
I20210921000783 DC Practitioner - Nurse Practitioner 7618141466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychogeriatric Services LLCGroup PAC ID 6002719226, 122 clinicians

Practice addresses (Care Compare)

12073 Tech Rd
Suite B
Silver Spring, MD 20904-7874
Phone (301) 593-1315

4101 Old National Pike
Pleasant View NH
Mt Airy, MD 21771-4115
Phone (301) 831-5850

7407 Willow Rd
Homewood Center at Crumland Farms
Frederick, MD 21702-2500
Phone (301) 644-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC CurrentSince Sep 9, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Frederick Primary Care Associates, P.a. PastSince Jan 1, 1997 Accepting new patients

Locations

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144372541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SOLAREX COURT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024384",
            "telephone_number": "301-694-7600",
            "fax_number": "301-228-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R131979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "N51966",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.