Amanda J Baltierra, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024167997 Issued in VA

Practice address

180 Grafton LN
Berryville, VA 22611-2576

Phone

(540) 955-2400

Fax

(540) 955-9765

NPI assigned

Mar 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1215996962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 112",
            "address_2": "180 GRAFTON LANE",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226110112",
            "telephone_number": "540-955-2400",
            "fax_number": "540-955-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 GRAFTON LN",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226112576",
            "telephone_number": "540-955-2400",
            "fax_number": "540-955-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTIERRA",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024167997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001726",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dandridge Berry Allen, D.D.S.
• Another Way Counseling
• Argyll Transport and Support Services, LLC
• Shaileen Robin Backman, LCSW
• Samantha Jean Baerhardt, MS, LPC
• Alicia Banks, OT
• Ebrahim H Baradaran, DMD
• Battletown Pharmacy, Inc.
• Samuel Bauman, PHD, LPC
• Behavioral Cusp

• Family Nurse Practitioner in Berryville, VA
• Providers in Berryville, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.