Individual provider Active NPI

Amanda Kay Graham, APRN

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1174175285
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11002696 Issued in FL
Practice address
1222 S Orange Ave
Orlando, FL 32806-1215
Phone
(321) 841-7856
Fax
(321) 843-6432
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11002696 FL Primary
Family Nurse Practitioner 363LF0000X 11002696 FL
General Practice Registered Nurse 163WG0000X 9375941 FL

Addresses

Primary practice location

1222 S Orange Ave
Orlando, FL 32806-1215

Mailing address

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (321) 841-7856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190916002354 FL Practitioner - Nurse Practitioner 1850620956 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
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (407) 650-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9375941FLMDGeneral Practice Registered Nurse
11002696FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2019 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
#812
Orlando, FL 32806

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: agraham28196@orlandohealth.medalliesdirect.net

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 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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1174175285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "AMANDA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11002696",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002696",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "9375941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.