Individual provider Active NPI

Amanda Marten, NP

  • Family Nurse Practitioner
  • Powder Springs, GA
National Provider Identifier
1326534504
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
240150 Issued in GA
Practice address
5230 Dallas Hwy
Powder Springs, GA 30127-4263
Phone
(404) 948-3019
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X GA240150 GA
Nurse Practitioner 363L00000X 812293 NV
Family Nurse Practitioner 363LF0000X APRN11007132 FL
Family Nurse Practitioner 363LF0000X 240150 GA Primary

Addresses

Primary practice location

5230 Dallas Hwy
Powder Springs, GA 30127-4263

Mailing address

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

Other practice location 1

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

Other practice location 2

975 Ryland St Ste 100
Reno, NV 89502-1669
Phone (775) 982-5000

Other names 1

  • Amanda Kirby Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230503001031 GA Practitioner - Nurse Practitioner 4880938380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

5230 Dallas Hwy
Powder Springs, GA 30127-4263
Phone (678) 732-1523

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GA240150GAMDCritical Care Medicine Registered Nurse
812293NVMDNurse Practitioner
240150GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC CurrentSince Apr 18, 2023 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

120 Marietta Hwy
Canton, GA 30114
Phone (678) 732-1510

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

5230 Dallas Hwy
Powder Springs, GA 30127
Phone (678) 732-1523

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.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1326534504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-420-8555",
            "fax_number": "561-420-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 DALLAS HWY",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301274263",
            "telephone_number": "404-948-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2007 Palm Beach Lakes Blvd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334096501",
            "country_code": "US",
            "telephone_number": "561-420-8555",
            "fax_number": "561-420-8550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 Ryland St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021669",
            "country_code": "US",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-5225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTEN",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "GA240150",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "812293",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007132",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "240150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KIRBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Powder Springs, GA

Sources for this page

Verify at the official NPI Registry.