Amanda Nicole Russell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012241 Issued in KY

Practice address

419 N Seminary St
Madisonville, KY 42431-1515

Phone

(731) 394-1145

NPI assigned

May 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pineville Community Health Center IncGroup PAC ID 5698009157, shared by 4 NPIs, 39 clinicians

Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Deaconess Madisonville Hospital, Madisonville, KY, CCN 180093

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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.

• Ultra Health LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1922469543

  KY

  Medicare reassignment Care Compare group NPD
• Brock Medical, LLC

  • Nurse Practitioner
  • London, KY
  • NPI 1023379815
  Medicare reassignment NPD
• Ultra Health Providers III LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1366307696

  KY

  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  KY

  Medicare reassignment
• Fast Pace Kentucky PLLC

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1669256913
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health Deaconess Madisonville Inc

  • Rural Acute Care Hospital
  • Madisonville, KY
  • NPI 1447231956
  Care Compare affiliation

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1215428578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269084",
            "address_2": "DEPT 1102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73126",
            "telephone_number": "731-394-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N SEMINARY ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311515",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Rogers
• Jarriel Rollins
• Amanda Diane Ross, CRNA
• Nikki J. Rothwell, PA-C
• John Alan Roy, DMD
• Gary Stephen Russell, R.PH.
• Lora A Russell, APRN
• Nicholas Stephen Russell, PHARMD
• Sacred Hands Private Care, LLC
• Steven Bradley Sampson, D.M.D.

• Family Nurse Practitioner in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.