Individual provider Active NPI

Amanda Ismail, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1164155859
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R231117 Issued in MD
Practice address
10450 Shaker Dr Ste 110
Columbia, MD 21046-2348
Phone
(410) 457-3196
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R231117 MD Primary

Addresses

Primary practice location

10450 Shaker Dr Ste 110
Columbia, MD 21046-2348

Mailing address

3010 Stonybrook Dr
Bowie, MD 20715-2234

Other practice location 1

200 Sutton St Ste 120
North Andover, MA 01845-1651
Phone (774) 206-1125

Other practice location 2

1 Radisson Plz Fl 8
New Rochelle, NY 10801-5766
Phone (332) 215-6631

Other practice location 3

340 Granite St Fl 3
Manchester, NH 03102-4000
Phone (603) 801-4714

Other practice location 4

2374 Post Rd Ste 107
Warwick, RI 02886-2270
Phone (401) 681-4637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R231117MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Family Services of Illinois, Inc. Past Accepting new patients
Northeast Family Services of New York Inc. PastSince May 8, 2024 Accepting new patients
Northeast Behavioral Associates Past Accepting new patients
Northeast Family Services of Illinois Past Accepting new patients
Northeast Family Services of New Hampshire, Inc. Past Accepting new patients
Northeast Behavioral Associates Inc. Past Accepting new patients

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1164155859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 STONYBROOK DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207152234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 SHAKER DR STE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462348",
            "telephone_number": "410-457-3196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Sutton St Ste 120",
            "address_purpose": "LOCATION",
            "city": "North Andover",
            "state": "MA",
            "postal_code": "018451651",
            "country_code": "US",
            "telephone_number": "774-206-1125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Radisson Plz Fl 8",
            "address_purpose": "LOCATION",
            "city": "New Rochelle",
            "state": "NY",
            "postal_code": "108015766",
            "country_code": "US",
            "telephone_number": "332-215-6631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Granite St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031024000",
            "country_code": "US",
            "telephone_number": "603-801-4714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2374 Post Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862270",
            "country_code": "US",
            "telephone_number": "401-681-4637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "AMANDA",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R231117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.