Amanda Marie Sallberg

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024188783 Issued in VA

Practice address

200 North Maple Avenue
Purcellville, VA 20132-6100

Phone

(540) 338-0177

NPI assigned

Jan 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baby Doc IncGroup PAC ID 7719397587, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Baby Doc Inc

  • Urgent Care Clinic/Center
  • Manassas, VA
  • NPI 1174004774
  Medicare reassignment Care Compare group NPD
• Falls Church Pediatrics

  • Primary Care Clinic/Center
  • Falls Church, VA
  • NPI 1588481576
  NPD

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1295597672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH MAPLE AVENUE",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201326100",
            "telephone_number": "540-338-0177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Market St Apt 331",
            "address_purpose": "LOCATION",
            "city": "Manassas Park",
            "state": "VA",
            "postal_code": "201113207",
            "country_code": "US",
            "telephone_number": "571-926-0922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALLBERG",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017805730001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295597672",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne M. Safko, M.D.
• Lima Sahibzada
• Christopher R Salas, D.D.S.
• Gabrielle Salazar, ATC, LAT
• Abdulhafidh Talib Salim, DDS
• Kelli Sanness, PHD, LPC
• Sharayu Sawant, MD
• Lillybeth Seng, IBCLC
• Martha Sharp, DDS
• Saad Shaukat

• Family Nurse Practitioner in Purcellville, VA
• Providers in Purcellville, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.