Individual provider Active NPI

Amanda McCalla, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Cordova, TN
National Provider Identifier
1255825113
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28106 Issued in TN
Practice address
57 Germantown CT Ste 100
Cordova, TN 38018-4274
Phone
(901) 435-8550
Fax
(901) 478-0781
NPI assigned
Jun 14, 2018
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 902677 MS
Family Nurse Practitioner 363LF0000X 902677 MS
Family Nurse Practitioner 363LF0000X 28106 TN Primary

Addresses

Primary practice location

57 Germantown CT Ste 100
Cordova, TN 38018-4274

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN, AR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180719000501 MS Practitioner - Nurse Practitioner 8921355132 Reassigns benefits to 2 organizations
I20201118001865 TN Practitioner - Nurse Practitioner 8921355132 Reassigns benefits to 2 organizations
I20210217002714 AR Practitioner - Nurse Practitioner 8921355132

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

4240 Bethel Rd
Suite 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200

57 Germantown CT
Suite 100
Cordova, TN 38018-4274
Phone (901) 435-8550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902677MSMDFamily Nurse Practitioner
28106TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Jun 20, 2018 Accepting new patients
Specialty Physician Group LLC Family CurrentSince Jun 16, 2025 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center CurrentSince Jun 20, 2018 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Methodist Healthcare - Olive Branch Hospital PastSince Jun 16, 2025 Accepting new patients

Locations

310 W Tyler Ave
West Memphis, AR 72301
Phone (870) 732-2398

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

611 Alcorn Dr
Ste 230
Corinth, MS 38834
Phone (662) 287-5218

4240 Bethel Rd
Ste 201
Olive Branch, MS 38654

4250 Bethel Rd
Fl 5
Olive Branch, MS 38654
Phone (662) 932-9544

57 Germantown Ct
Ste 100
Cordova, TN 38018
Phone (901) 435-8550

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

Interoperability endpoints

  • Direct secure messaging: amanda.mccalla.p1@direct.phvvmed.nextgenshare.com

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1255825113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GERMANTOWN CT STE 100",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184274",
            "telephone_number": "901-435-8550",
            "fax_number": "901-478-0781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4240 Bethel Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386548737",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCALLA",
        "first_name": "AMANDA",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "902677",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902677",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "28106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.