Individual provider Active NPI

Amanda Stephens, NP

  • Family Nurse Practitioner
  • Athens, GA
National Provider Identifier
1194148767
Registry record updated Feb 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN175504 Issued in GA
Practice address
120 Trinity PL
Athens, GA 30607-2100
Phone
(706) 543-2718
NPI assigned
Feb 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2014

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 RN175504 GA Primary

Addresses

Primary practice location

120 Trinity PL
Athens, GA 30607-2100

Mailing address

135 Bear Paw CT
Bogart, GA 30622-5183
Phone (706) 202-1483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141021000087 GA Practitioner - Nurse Practitioner 4183845993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1181 Langford Dr
Suite 105
Watkinsville, GA 30677-7242

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN175504GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMB Medical Associates, P.C. Family CurrentSince Mar 19, 2018 Accepting new patients

Locations

2470 Daniells Bridge Rd
Ste 221
Athens, GA 30606
Phone (706) 389-3180

1181 Langford Dr
Bldg 200
Watkinsville, GA 30677
Phone (706) 548-9655

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGFHAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGFHAA/Endpoint/CGFHAA

Organizations & group practices 1

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 2

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": "1391212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391212800000",
    "number": "1194148767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BEAR PAW CT",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306225183",
            "telephone_number": "706-202-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TRINITY PL",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306072100",
            "telephone_number": "706-543-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-01",
        "last_updated": "2014-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN175504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.