Individual provider Active NPI

Amanda R Blount, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1225701790
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218673 Issued in LA
Practice address
1715 Wolf Cir
Lake Charles, LA 70605-2353
Phone
(337) 480-7499
Fax
(337) 480-7498
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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 218673 LA Primary

Addresses

Primary practice location

1715 Wolf Cir
Lake Charles, LA 70605-2353

Mailing address

PO Box 122525 Dept 2525
Dallas, TX 75312-0001
Phone (337) 494-2772

Other identifiers 2

IdentifierTypeStateIssuer
218673OtherLASTATE FNP LICENSE
2571532MedicaidLA

Other names 1

  • Amanda Murray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210825004225 LA Practitioner - Nurse Practitioner 4486059649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Charles Medical Services Urology LLCGroup PAC ID 4284738063, 5 clinicians

Practice addresses (Care Compare)

1715 Wolf Cir
Lake Charles, LA 70605-2353
Phone (337) 480-7499

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
218673LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Medical Services Urology LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

1715 Wolf Cir
Lake Charles, LA 70605
Phone (337) 480-7499

2770 3rd Ave
Ste 240
Lake Charles, LA 70601
Phone (337) 494-4656

619 S Huntington St
Sulphur, LA 70663
Phone (337) 494-3278

3924 Maplewood Dr
Sulphur, LA 70663
Phone (337) 494-6768

Interoperability endpoints

  • Direct secure messaging: ablount5281949@direct.casso.us.com

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 10

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1225701790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122525 DEPT 2525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "337-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 WOLF CIR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052353",
            "telephone_number": "337-480-7499",
            "fax_number": "337-480-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOUNT",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "218673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE FNP LICENSE",
            "identifier": "218673",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2571532",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MURRAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.