Individual provider Active NPI

Amanda Leigh Harrell, F.N.P.-C

  • Family Nurse Practitioner
  • Deridder, LA
National Provider Identifier
1295082568
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08787 Issued in LA
Practice address
600 S Pine St
Deridder, LA 70634-4942
Phone
(337) 462-7100
NPI assigned
Aug 6, 2012
Last updated
Jun 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP08787 LA Primary
Registered Nurse 163W00000X RN122253 LA

Addresses

Primary practice location

600 S Pine St
Deridder, LA 70634-4942

Mailing address

PO Box 504
Dry Creek, LA 70637-0504
Phone (337) 302-2739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20161121001056 LA Practitioner - Nurse Practitioner 9537453618 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beauregard Medical and Surgical Center, LLCGroup PAC ID 6709066541, 3 clinicians

Practice addresses (Care Compare)

301 S Washington St
Deridder, LA 70634-4861
Phone (337) 460-7688

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN122253LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Beauregard Surgery Center, LLC CurrentSince Oct 14, 2017 Accepting new patients
Concord Medical Group PLLC CurrentSince Sep 16, 2016 Accepting new patients
West Louisiana Health Services Inc CurrentSince Oct 21, 2020 Accepting new patients
Rapides Healthcare System LLC CurrentSince Mar 1, 2020 Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince May 1, 2020 Accepting new patients
Beauregard Medical and Surgical Center, LLC CurrentSince Oct 14, 2017 Accepting new patients
Beauregard Family Medical Center, LLC CurrentSince Oct 14, 2017 Accepting new patients
Rapides Healthcare System, LLC Current Accepting new patients
Calcasieu Urgent Care LLC CurrentSince May 1, 2020 Accepting new patients
Rapides Healthcare System, LLC CurrentSince Mar 1, 2020 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Sep 16, 2016 Accepting new patients
Beauregard Women's Health Center, LLC CurrentSince Oct 14, 2017 Accepting new patients
Hospital Service District No 2 of Parish of Beauregard State of la Current Accepting new patients
Beauregard Urology Center, LLC CurrentSince Oct 14, 2017 Accepting new patients
Hospital Service District No 2 of Parish of Beauregard State of la Past Accepting new patients
Chuen K Kwok Ms Apmc PastSince Oct 14, 2017 Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

200 W 5th St
Deridder, LA 70634
Phone (337) 221-1417

206 W 5th St
Deridder, LA 70634
Phone (337) 462-7106

301 S Washington St
Deridder, LA 70634
Phone (337) 460-7688

302 W 6th St
Deridder, LA 70634
Phone (337) 463-8556

316 W 7th St
Deridder, LA 70634
Phone (337) 462-1400

495 W 8th St
Deridder, LA 70634
Phone (337) 462-2262

501 S Pine St
Deridder, LA 70634
Phone (337) 462-3937

501 S Pine St
#C
Deridder, LA 70634
Phone (337) 463-9890

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

2900 Gerstner Memorial Dr
Lake Charles, LA 70601
Phone (337) 485-4185

3439 Highway 1256
Sulphur, LA 70665
Phone (337) 607-0037

Interoperability endpoints

  • Direct secure messaging: amanda.harrell@beauregard.medalliesdirect.net

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

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": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1295082568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504",
            "city": "DRY CREEK",
            "state": "LA",
            "postal_code": "706370504",
            "telephone_number": "337-302-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344942",
            "telephone_number": "337-462-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08787",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN122253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

Verify at the official NPI Registry.