Amanda Northeim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1245873223 Issued in NC

Practice address

2301 Erwin Rd
Durham, NC 27710-3618

Phone

(919) 684-8111

NPI assigned

Oct 23, 2019

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anortheim513001@direct.medicine.duke.edu

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.

• Duke University Health System, Inc.

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977
  Medicare reassignment
• Duke University Health System, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD
• Duke University Health System, Inc.

  • Social Worker
  • Durham, NC
  • NPI 1497912232
  NPD
• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  NPD (past)
• Duke University Health System, Inc.

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1376574798
  NPD (past)

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1245873223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6260",
            "fax_number": "239-343-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277103618",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9981 S Healthpark Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083618",
            "country_code": "US",
            "telephone_number": "239-343-6260",
            "fax_number": "239-343-6259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORTHEIM",
        "first_name": "AMANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112766",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1245873223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104659800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Durham Women'S Health
• North to South Services Inc
• North to South Services Inc.
• Kathryn North, LPA
• Northcore Management Group LLC
• Northland Hearing Center, Inc.
• Gabriella Michelle Norton, AUD
• Sarah Eastman Norton
• Kate Elizabeth Norwalk, PHD
• Arden Norwood, LCMHCA, MED

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.