Amanda E Nichols, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

08915 Issued in OH

Practice address

30575 Bainbridge Rd Ste 300
Solon, OH 44139-2275

Phone

(440) 368-6868

Fax

(440) 368-6866

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Amanda E Weatherby Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD
• Mills Medical Practices, LLC

  • Primary Care Clinic/Center
  • Beachwood, OH
  • NPI 1477701969
  Medicare reassignment NPD
• Alliance Physicians Inc

  dba Kettering Reproductive Medicine

  • Reproductive Endocrinology Physician
  • Kettering, OH
  • NPI 1578824033
  NPD
• Mills Medical Practices, LLC

  dba Virginia Home Based Primary Care

  • Primary Care Clinic/Center
  • Abingdon, VA
  • NPI 1841920287
  NPD
• Andrew D Grubbs

  • Geriatric Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1942245626

  Family

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Miamisburg

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1154341741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30575 BAINBRIDGE RD STE 300",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392275",
            "telephone_number": "440-368-6868",
            "fax_number": "440-368-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30575 BAINBRIDGE RD STE 300",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392275",
            "telephone_number": "440-368-6868",
            "fax_number": "440-368-6866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6661 Clyo Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454592702",
            "country_code": "US",
            "telephone_number": "937-425-4000",
            "fax_number": "937-425-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "08915",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN293365",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200831990",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78017902",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2679463",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anichols567827@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "6661 Clyo Rd",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454592702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6661 Clyo Rd",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454592702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WEATHERBY",
            "middle_name": "E",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Muneera Y Novak, LISW

• Family Nurse Practitioner in Solon, OH
• Providers in Solon, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.