Amanda Sullivan Bahler, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

6612 Issued in CT

Practice address

105 Carnegie PL Ste 103
Fayetteville, GA 30214-5900

Phone

(770) 716-7999

Fax

(770) 716-8444

NPI assigned

Aug 22, 2016

Last updated

May 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Pegeen Sullivan Former name

Medicare fee-for-service enrollment

Enrolled in CT, FL, NY, GA4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.bahler@xdr.hhchealthdirect.org
• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Southeast Medical Group, P.C.

  dba North Atlanta Primary Care, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment NPD
• Transtreme, LLC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1003290453

  FL, NY

  Medicare reassignment NPD
• Physician First Health Network

  • Public Health or Welfare Agency
  • Alpharetta, GA
  • NPI 1598558181
  NPD (past)
• Rocky Mountain Kidney Care Professional Service Corp

  dba South Texas Kidney & Hypertension Clinic

  • Nephrology Physician
  • Weslaco, TX
  • NPI 1558181636
  NPD (past)
• Usrc Southeast Sarasota LLC

  dba U.S. Renal Care Palmer Ranch Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sarasota, FL
  • NPI 1275193070
  NPD (past)

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1245785013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061025037",
            "telephone_number": "860-545-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL STE 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302145900",
            "telephone_number": "770-716-7999",
            "fax_number": "770-716-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHLER",
        "first_name": "AMANDA",
        "middle_name": "SULLIVAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "6612",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "6612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SULLIVAN",
            "middle_name": "PEGEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen J Aycock, PH.D.
• Timothy James Aycock, PHD
• Kristin Renee Ayers, DPT
• Babbling Bunch Speech Therapy LLC
• S. Bernard Bagley, LCSW
• Kendra Bailey-Lyon, PT
• Alisha Bailey, RBT
• Courtney Mels Bailey, NP
• Elizabeth Baker, RBT
• Susan Stooksbury Baker, PT, MS

• Acute Care Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.