NPIMap

Individual provider Active NPI

Amanda L Freeman, FNP

  • Nurse Practitioner
  • Waynesboro, MS
National Provider Identifier
1215209986
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R781277 Issued in MS
Practice address
951 Matthew Drive
Suite# a
Waynesboro, MS 39367
Phone
(601) 371-2742
Fax
(601) 735-7266
NPI assigned
Jan 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R781277 MS Primary

Addresses

Primary practice location

951 Matthew Drive
Suite# a
Waynesboro, MS 39367

Mailing address

951 Matthew Drive
Suite# a
Waynesboro, MS 39367
Phone (601) 371-2742

Other identifiers 1

IdentifierTypeStateIssuer
R781277OtherMSST LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120215000809 MS Practitioner - Nurse Practitioner 4880852185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne General Hospital 47 clinicians

Practice addresses (Care Compare)

951 Matthew Dr
Suite a
Waynesboro, MS 39367-2566
Phone (601) 735-2401

Hospital & facility affiliations

  • Wayne General Hospital HHA Home health agency, Waynesboro, MS, CCN 257088
  • Wayne General Hospital Hospital, Waynesboro, MS, CCN 250077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R781277MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne General Hospital Current Accepting new patients
Wayne General Hospital CurrentSince Apr 15, 2024 Accepting new patients
Coastal Family Health Center, Inc CurrentSince Oct 21, 2017 Accepting new patients
Wayne General Hospital CurrentSince Apr 15, 2024 Accepting new patients
Coastal Family Health Center, Inc CurrentSince Oct 21, 2017 Accepting new patients
South Central Clinics, Inc Past Accepting new patients
Wayne General Hospsital Past Accepting new patients
Wayne General Hospital Past Accepting new patients

Locations

1046 Division St
Biloxi, MS 39530
Phone (225) 374-2494

1616 Williams Dr
Leakesville, MS 39451
Phone (601) 394-2381

256 Main St
State Line, MS 39362
Phone (601) 848-7912

950 Matthew Dr
Waynesboro, MS 39367
Phone (601) 735-5151

1325 Azalea Dr
Waynesboro, MS 39367
Phone (601) 671-2825

940 Matthew Dr
Ste 8
Waynesboro, MS 39367
Phone (601) 735-1030

951 Matthew Dr
Ste A
Waynesboro, MS 39367
Phone (601) 735-2401

Interoperability endpoints

  • Direct secure messaging: amanda.freeman.p1@direct.cfhc.nextgenshare.com

Organizations & group practices 13

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.

View all 13

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": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1215209986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 MATTHEW DRIVE",
            "address_2": "SUITE# A",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "39367",
            "telephone_number": "601-371-2742",
            "fax_number": "601-735-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 MATTHEW DRIVE",
            "address_2": "SUITE# A",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "39367",
            "telephone_number": "601-371-2742",
            "fax_number": "601-735-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "AMANDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R781277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LICENSE NUMBER",
            "identifier": "R781277",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, MS

Sources for this page

Verify at the official NPI Registry.