Individual provider Active NPI

Amanda Jane Brashear, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1174317259
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71017365A Issued in IN
Practice address
3577 W Cockrell Rd
Bloomington, IN 47403-8710
Phone
(812) 327-0171
NPI assigned
Apr 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 71017365A IN Primary

Addresses

Primary practice location

3577 W Cockrell Rd
Bloomington, IN 47403-8710

Mailing address

3577 W Cockrell Rd
Bloomington, IN 47403-8710
Phone (812) 327-0171

Other practice location 1

901 S Rogers St Ste 101
Bloomington, IN 47403-4760
Phone (812) 322-4979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20251217003972 IN Practitioner - Nurse Practitioner 6901391945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3577 W Cockrell Rd
Bloomington, IN 47403-8710

6326 Constitution Dr
Fort Wayne, IN 46804-1518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71017365AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brashear Psychiatric Services, LLC Psychiatric/Mental Health CurrentSince Apr 6, 2025 Accepting new patients
Haven'S Holistic Healing LLC CurrentSince Dec 9, 2025 Accepting new patients

Locations

901 S Rogers St
Ste 101
Bloomington, IN 47403
Phone (812) 322-4979

6280 N College Ave
Ste 150
Indianapolis, IN 46220
Phone (518) 246-6884

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1174317259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3577 W COCKRELL RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474038710",
            "telephone_number": "812-327-0171",
            "fax_number": "317-669-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W COCKRELL RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474038710",
            "telephone_number": "812-327-0171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S Rogers St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474034760",
            "country_code": "US",
            "telephone_number": "812-322-4979",
            "fax_number": "317-669-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASHEAR",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-05",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71017365A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.