Individual provider Active NPI

Amanda Heffernan, CNM

  • Advanced Practice Midwife
  • Seattle, WA
National Provider Identifier
1154742609
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP61115862 Issued in WA
Practice address
9245 Rainier Ave S
Seattle, WA 98118-5569
Phone
(206) 722-8444
Fax
(206) 721-6310
NPI assigned
Jan 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP5361 AZ
Advanced Practice Midwife 367A00000X AP61115862 WA Primary

Addresses

Primary practice location

9245 Rainier Ave S
Seattle, WA 98118-5569

Mailing address

1200 12TH Ave S Ste 901
Seattle, WA 98144-2712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 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
I20210630003609 WA Practitioner - Nurse Practitioner 9830322254 Reassigns benefits to 1 organization
I20231212003076 WA Practitioner - Certified Nurse Midwife (CNM) 9830322254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
AP5361AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Aug 2, 2021 Accepting new patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Oct 15, 2023 Accepting new patients
Neighborcare Health CurrentSince Aug 2, 2021 Accepting new patients
Neighborcare Health Current Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

Interoperability endpoints

  • Direct secure messaging: aheffernan351299@direct.ochin.org

Organizations & group practices 6

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": "1388534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1154742609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981185569",
            "telephone_number": "206-722-8444",
            "fax_number": "206-721-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "AMANDA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-01",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "AP5361",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP61115862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.