Individual provider Active NPI

Amber Anderson, NP

  • Acute Care Nurse Practitioner
  • Cleveland, TN
National Provider Identifier
1184359309
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
32017 Issued in TN
Practice address
2253 Chambliss Ave NW Ste 400
Cleveland, TN 37311-3861
Phone
(423) 476-5002
Fax
(423) 476-5969
NPI assigned
Jul 21, 2022
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 32017 TN Primary
Critical Care Medicine Registered Nurse 163WC0200X 210895 TN

Addresses

Primary practice location

2253 Chambliss Ave NW Ste 400
Cleveland, TN 37311-3861

Mailing address

2253 Chambliss Ave NW Ste 400
Cleveland, TN 37311-3861
Phone (423) 476-5002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 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
I20221208001945 NC Practitioner - Nurse Practitioner 4284003500 Reassigns benefits to 1 organization
I20231117000695 TN Practitioner - Nurse Practitioner 4284003500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Bradley Physician Services, LLCGroup PAC ID 8123563392, 77 clinicians

Practice addresses (Care Compare)

2253 Chambliss Ave NW
Suite 400
Cleveland, TN 37311-3861
Phone (423) 472-5986

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210895TNMDCritical Care Medicine Registered Nurse
32017TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Bradley Physician Services, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2253 Chambliss Ave NW
Ste 400
Cleveland, TN 37311
Phone (423) 472-5986

2700 Westside Dr NW
Ste 204
Cleveland, TN 37312
Phone (423) 476-3711

2800 Westside Dr NW
Cleveland, TN 37312
Phone (423) 339-4100

Interoperability endpoints

  • Direct secure messaging: amber.anderson.1@31613.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1184359309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 400",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-476-5002",
            "fax_number": "423-476-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 400",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-476-5002",
            "fax_number": "423-476-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMBER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "32017",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "210895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.