Individual provider Active NPI

Amanda Jordan, APRN-CNP

  • Family Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1215602941
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142824 Issued in TX
Practice address
5517 S Alameda St
Corpus Christi, TX 78412-3202
Phone
(361) 994-1214
NPI assigned
Aug 13, 2021
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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 AP142824 TX Primary

Addresses

Primary practice location

5517 S Alameda St
Corpus Christi, TX 78412-3202

Mailing address

6817 Jets CT
Corpus Christi, TX 78414-4172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230801000482 TX Practitioner - Nurse Practitioner 4880913813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Rabagos Health Care PLLCGroup PAC ID 5991926032, 17 clinicians

Practice addresses (Care Compare)

500 E Caesar Ave
Statcare Minor Emergency Clinic
Kingsville, TX 78363-6322
Phone (361) 516-0800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP142824TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rabagos Health Care PLLC CurrentSince Jul 1, 2024 Accepting new patients
QC Professional PLLC PastSince Jul 1, 2024 Accepting new patients

Locations

7201 Mansions Dr
Corpus Christi, TX 78414
Phone (361) 334-1040

6646 S Staples St
Ste 122
Corpus Christi, TX 78413
Phone (361) 334-2023

3817 Spid Dr
Corpus Christi, TX 78415
Phone (361) 334-2035

4042 River Hill Dr
Corpus Christi, TX 78410
Phone (361) 933-5187

500 E Caesar Ave
Kingsville, TX 78363
Phone (361) 516-0097

2102 FM 2165
Rockport, TX 78382
Phone (361) 556-5770

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1215602941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 JETS CT",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5517 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784123202",
            "telephone_number": "361-994-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMANDA",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.