Individual provider Active NPI

Amanda Lizer

  • Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1144813973
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3015505 Issued in KY
Practice address
330 Romany Rd
Lexington, KY 40502-2404
Phone
(859) 266-2495
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3015505 KY
Nurse Practitioner 363L00000X 3015505 KY Primary

Addresses

Primary practice location

330 Romany Rd
Lexington, KY 40502-2404

Mailing address

143 Fallow Cir
Georgetown, KY 40324-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210409001402 KY Practitioner - Nurse Practitioner 4385052430 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1140 Lexington Rd
Georgetown, KY 40324-9330
Phone (502) 868-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3015505KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Urgent Care PLLC Nurse Practitioner CurrentSince Jun 21, 2023 Accepting new patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Mar 22, 2024 Accepting new patients
Georgetown Urgent Care PLLC Nurse Practitioner CurrentSince Jun 21, 2023 Accepting new patients
Berea Urgent Care LLC Nurse Practitioner CurrentSince Jul 21, 2023 Accepting new patients
Man O War Urgent Care LLC Nurse Practitioner CurrentSince Jun 21, 2023 Accepting new patients

Locations

234 Brenwood St
Berea, KY 40403
Phone (859) 985-0302

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

111 Osborne Way
#101
Georgetown, KY 40324
Phone (859) 466-8956

4097 Nichols Park Dr
Ste 108
Lexington, KY 40503
Phone (859) 245-2273

1701 Nicholasville Rd
Ste 100
Lexington, KY 40503
Phone (859) 466-8956

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1144813973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 FALLOW CIR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403247007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ROMANY RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022404",
            "telephone_number": "859-266-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015505",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3015505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.