Individual provider Active NPI

Amanda Carlene Lucero Hanks, APRN

  • Adult Health Nurse Practitioner
  • Sebring, FL
National Provider Identifier
1316913239
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN2980082 Issued in FL
Practice address
131 W Center Ave
Sebring, FL 33870
Phone
(863) 658-1764
Fax
(855) 847-7646
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2980082 FL
Family Nurse Practitioner 363LF0000X ARNP2980082 FL
Adult Health Nurse Practitioner 363LA2200X APRN2980082 FL Primary

Addresses

Primary practice location

131 W Center Ave
Sebring, FL 33870

Mailing address

131 W Center Ave
Sebring, FL 33870-3104
Phone (863) 658-1764

Other identifiers 2

IdentifierTypeStateIssuer
307168500MedicaidFL
307168500MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060117000876 FL Practitioner - Nurse Practitioner 3577587542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

131 W Ctr Ave
Sebring, FL 33870-3104
Phone (863) 658-1764

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2980082FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Customized Wellness, LLC CurrentSince Oct 12, 2019 Accepting new patients
Florida Hospital Medical Group Inc Past Accepting new patients

Locations

131 W Center Ave
Sebring, FL 33870
Phone (863) 658-1764

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 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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1316913239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W CENTER AVE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338703104",
            "telephone_number": "863-658-1764",
            "fax_number": "855-847-7646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W CENTER AVE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-658-1764",
            "fax_number": "855-847-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKS",
        "first_name": "AMANDA",
        "middle_name": "CARLENE LUCERO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "2980082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2980082",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN2980082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307168500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307168500",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.