Amanda Lyn Carlson, DNP, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

202109536NP-PP Issued in OR

Practice address

1340 NW Wall St
Bend, OR 97703-1985

Phone

(541) 322-7500

Fax

(541) 322-7565

NPI assigned

Jun 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: acarlson645937@direct.ochin.org

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.

• St. Charles Health System, Inc.

  dba St. Charles Medical Center - Bend

  • Rehabilitation Hospital Unit
  • Bend, OR
  • NPI 1154343150
  NPD (past)

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1306460647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017752",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 NW WALL ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031985",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 W Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Sisters",
            "state": "OR",
            "postal_code": "977592619",
            "country_code": "US",
            "telephone_number": "541-549-9609",
            "fax_number": "541-278-8349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3461 Cedar Dr",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "UT",
            "postal_code": "840985499",
            "country_code": "US",
            "telephone_number": "320-250-8916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "AMANDA",
        "middle_name": "LYN",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "10286389-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202109536NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ineke M. Carey, R.D,, C.D.
• Leslie Anne Carey, M.D.
• Farrah Suzanne Carkhuff, CRM
• Hannah Schonau Carlsen, DPT
• Thomas J Carlsen, MD
• Anne Carlson, ICCE
• James Michael Carlson, DO
• Kayla Anne Carlson, PA-S
• Margaret Louise Carlson, B.S., L.M.T.
• Jessica Lindsey Carlton, LAC

• Family Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.