Individual provider Active NPI

Amanda Nicole Coon, FNP

  • Vascular Surgery Physician
  • Fredericksburg, VA
National Provider Identifier
1265304489
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0024194730 Issued in VA
Practice address
1101 Sam Perry Blvd Ste 400
Fredericksburg, VA 22401-4466
Phone
(540) 741-2865
NPI assigned
Sep 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0024194730 VA
Vascular Surgery Physician 2086S0129X 0024194730 VA Primary

Addresses

Primary practice location

1101 Sam Perry Blvd Ste 400
Fredericksburg, VA 22401-4466

Mailing address

6900 Ridge Way Dr
Fredericksburg, VA 22407-6276
Phone (804) 205-0510

Other practice location 1

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260127001308 VA Practitioner - Nurse Practitioner 2466939996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians

Practice addresses (Care Compare)

1101 Sam Perry Blvd
Fredericksburg, VA 22401-4466
Phone (540) 741-2871

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024194730VAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Providers LLC Surgery CurrentSince Dec 15, 2025 Accepting new patients
Mary Washington Hospital Inc. PastSince Sep 21, 2025 Accepting new patients

Locations

1101 Sam Perry Blvd
Ste 400
Fredericksburg, VA 22401
Phone (540) 741-2865

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1265304489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 RIDGE WAY DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076276",
            "telephone_number": "804-205-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 400",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014466",
            "telephone_number": "540-741-2865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014453",
            "country_code": "US",
            "telephone_number": "540-741-1240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COON",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0024194730",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0024194730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.