Individual provider Active NPI

Amanda Patterson Kindel, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1265003792
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904727 Issued in MS
Practice address
5003 Hardy St Ste 100
Hattiesburg, MS 39402-1331
Phone
(601) 475-9968
NPI assigned
Jul 6, 2021
Last updated
Sep 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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 904727 MS Primary

Addresses

Primary practice location

5003 Hardy St Ste 100
Hattiesburg, MS 39402-1331

Mailing address

5003 Hardy St Ste 100
Hattiesburg, MS 39402-1331
Phone (601) 475-9968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220124002748 MS Practitioner - Nurse Practitioner 1557753589 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
David B Roy DO PAGroup PAC ID 2365767118, 10 clinicians

Practice addresses (Care Compare)

201 S Main St
Petal, MS 39465-2362
Phone (601) 336-5626

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
81.89
Promoting interoperability
100
Improvement activities
40
Cost
71.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David B Roy DO PA CurrentSince Oct 1, 2021 Accepting new patients

Locations

1244 Highway 29 N
Ellisville, MS 39437
Phone (601) 261-5771

102 E Hospital Dr
Hattiesburg, MS 39402
Phone (601) 268-5144

201 S Main St
Petal, MS 39465
Phone (601) 336-5626

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1265003792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5003 HARDY ST STE 100",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021331",
            "telephone_number": "601-475-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 HARDY ST STE 100",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021331",
            "telephone_number": "601-475-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDEL",
        "first_name": "AMANDA",
        "middle_name": "PATTERSON",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.