Individual provider Active NPI

Amanda Chitsey, APN

  • Nurse Practitioner
  • Harrison, AR
National Provider Identifier
1265401160
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A01409 Issued in AR
Practice address
6166 Hwy 206 West
Harrison, AR 72601-9235
Phone
(870) 424-7070
Fax
(870) 424-6616
NPI assigned
Mar 14, 2006
Last updated
Oct 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A01409 AR Primary

Addresses

Primary practice location

6166 Hwy 206 West
Harrison, AR 72601-9235

Mailing address

PO Box 2458
Mountain Home
Mountain Home, AR 72654-2458
Phone (870) 424-7070

Other identifiers 2

IdentifierTypeStateIssuer
157479758MedicaidAR
500007023OtherARRAILROAD #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20050630000439 AR Practitioner - Nurse Practitioner 4688610553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Harrison, AR 72601
Phone (870) 365-2829

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison Family Practice Clinic, PA Past Accepting new patients
Washington Regional Medical System Past Accepting new patients

Organizations & group practices 3

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1265401160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2458",
            "address_2": "MOUNTAIN HOME",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726542458",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6166 HWY 206 WEST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726019235",
            "telephone_number": "870-424-7070",
            "fax_number": "870-424-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITSEY",
        "first_name": "AMANDA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A01409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157479758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD #",
            "identifier": "500007023",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

Verify at the official NPI Registry.