Individual provider Active NPI

Amanda G Marshall, APRN

  • Family Nurse Practitioner
  • Maysville, KY
National Provider Identifier
1154871804
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3010756 Issued in KY
Practice address
910 Kenton Station Dr
Suite C
Maysville, KY 41056-9613
Phone
(606) 759-0017
Fax
(606) 759-0573
NPI assigned
Oct 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3010756 KY
Family Nurse Practitioner 363LF0000X 3010756 KY Primary

Addresses

Primary practice location

910 Kenton Station Dr
Suite C
Maysville, KY 41056-9613

Mailing address

100 E Liberty St
Suite 800
Louisville, KY 40202-1434

Other practice location 1

79 Country Club Dr
Butler, KY 41006-8704
Phone (859) 654-2283

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
I20161116000756 KY Practitioner - Nurse Practitioner 8224317268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

79 Country Club Dr
Butler, KY 41006-8704
Phone (859) 654-2283

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jun 17, 2024 Accepting new patients
Summit Medical Group, Inc. Nurse Practitioner CurrentSince Jun 17, 2024 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner Current Accepting new patients

Locations

79 Country Club Dr
Butler, KY 41006
Phone (859) 344-5481

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

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 3

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": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1154871804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "SUITE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 KENTON STATION DR",
            "address_2": "SUITE C",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410569613",
            "telephone_number": "606-759-0017",
            "fax_number": "606-759-0573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 Country Club Dr",
            "address_purpose": "LOCATION",
            "city": "Butler",
            "state": "KY",
            "postal_code": "410068704",
            "country_code": "US",
            "telephone_number": "859-654-2283",
            "fax_number": "859-654-2284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "AMANDA",
        "middle_name": "G",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010756",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

Verify at the official NPI Registry.