Amanda Lynne Mitchell, NP

Key facts

NPI

1235916909

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

License

5018812 (NC)

Practice address

2206 Wrightsville Ave Ste a
Wilmington, NC 28403-2406

Phone

(910) 251-5326

Fax

(910) 632-2355

NPI assigned

Sep 14, 2023

Sex

Female

Sole proprietor

Yes

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 and National Provider Directory roles.

• Nautilus Mental Health PLLC Community/Behavioral Health Agency · Wilmington, NC · NPI 1194607283
  Medicare reassignment NPD Authorized official NC
• Port Health Services Counselor · Greenville, NC · NPI 1497075618
  Medicare reassignment NPD NC
• Port Health Services Community/Behavioral Health Agency · Whiteville, NC · NPI 1174005789
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 14, 2023.

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1235916909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 WRIGHTSVILLE AVE STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032406",
            "telephone_number": "910-251-5326",
            "fax_number": "910-632-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 WRIGHTSVILLE AVE STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032406",
            "telephone_number": "910-251-5326",
            "fax_number": "910-632-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AMANDA",
        "middle_name": "LYNNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5018812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

• Zach Harmon Mishoe, MS, LAT, ATC
• Taylor A. Miskech, PT, DPT
• Mission Medstaff, LLC
• Julie A Mistovich, PTA
• Amalia Mistreanu
• Antavia S Mitchell
• Hayley Mitchell, PA-C
• Justin Mitchell, LCSW-A
• Lori June Mitchell, PHARM D
• Matthew Hunter Mitchell

All providers in Wilmington, NC · Psychiatric/Mental Health Nurse Practitioner in North Carolina