Individual provider Active NPI

Amanda Rhoads

  • Family Nurse Practitioner
  • El Segundo, CA
National Provider Identifier
1164822789
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60502434 Issued in WA
Practice address
740 S Allied Way
El Segundo, CA 90245-5514
Phone
(310) 500-2045
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 60502434 WA Primary

Addresses

Primary practice location

740 S Allied Way
El Segundo, CA 90245-5514

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

16549 Aurora Ave N
Shoreline, WA 98133-5308
Phone (206) 788-3650

Other practice location 2

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OK2 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
I20200407002997 CA Practitioner - Nurse Practitioner 1759502685 Reassigns benefits to 1 organization
I20240129003727 OK Practitioner - Nurse Practitioner 1759502685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60502434WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Nov 21, 2023 Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Apr 1, 2020 Accepting new patients
Ou Health Partners, Inc CurrentSince Nov 21, 2023 Accepting new patients
Saint John'S Health Clinic PastSince May 3, 2020 Accepting new patients
One Medical Seniors Group, Inc. PastSince May 3, 2020 Accepting new patients

Locations

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1200 Childrens Ave
Oklahoma City, OK 73104
Phone (405) 271-2429

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: amanda.rhoads@coh.eclinicaldirectplus.com

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": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1164822789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S ALLIED WAY",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455514",
            "telephone_number": "310-500-2045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16549 Aurora Ave N",
            "address_purpose": "LOCATION",
            "city": "Shoreline",
            "state": "WA",
            "postal_code": "981335308",
            "country_code": "US",
            "telephone_number": "206-788-3650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHOADS",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "60502434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.