Individual provider Active NPI

Amanda Lynn Ward

  • Family Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1164905238
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012688 Issued in KY
Practice address
1200 Breckenridge St
Owensboro, KY 42303-1090
Phone
(270) 683-8672
Fax
(270) 685-8223
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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 3012688 KY Primary

Addresses

Primary practice location

1200 Breckenridge St
Owensboro, KY 42303-1090

Mailing address

1200 Breckenridge St
Owensboro, KY 42303-1089
Phone (270) 684-0028

Other identifiers 2

IdentifierTypeStateIssuer
7100572330MedicaidKY
K255400OtherKYMEDICARE

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
I20181102000826 KY Practitioner - Nurse Practitioner 8224381561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Medical Practice, PLLCGroup PAC ID 0446157671, 20 clinicians

Practice addresses (Care Compare)

1200 Breckenridge St
Owensboro, KY 42303-1089
Phone (270) 683-8672

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3012688KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Medical Practice, PLLC Family CurrentSince Oct 15, 2018 Accepting new patients
Owensboro Medical Practice, PLLC Family PastSince Oct 15, 2018 Accepting new patients

Locations

1200 Breckenridge St
Ste 102
Owensboro, KY 42303
Phone (270) 683-8672

1200 Breckenridge St
Ste 101
Owensboro, KY 42303
Phone (270) 683-8672

1126 Triplett St
Ste 102
Owensboro, KY 42303
Phone (270) 687-9000

1200 Breckenridge St
Owensboro, KY 42303
Phone (270) 683-8672

Interoperability endpoints

  • Direct secure messaging: amanda.ward.p1@direct.omp.nextgenshare.com

Organizations & group practices 2

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 1

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": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1164905238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BRECKENRIDGE ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031089",
            "telephone_number": "270-684-0028",
            "fax_number": "270-685-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRECKENRIDGE ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031090",
            "telephone_number": "270-683-8672",
            "fax_number": "270-685-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100572330",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K255400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.