NPIMap

Individual provider Active NPI

Amanda S. Brock, ANP

  • Women's Health Nurse Practitioner
  • Batesville, AR
National Provider Identifier
1336462712
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
A03334ANP Issued in AR
Practice address
1215 Sidney St
Suite 202
Batesville, AR 72501-7203
Phone
(870) 262-2000
NPI assigned
Mar 12, 2010
Last updated
Mar 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X A03334ANP AR Primary

Addresses

Primary practice location

1215 Sidney St
Suite 202
Batesville, AR 72501-7203

Mailing address

1215 Sidney St
Suite 202
Batesville, AR 72501-7203
Phone (870) 262-2000

Other identifiers 1

IdentifierTypeStateIssuer
A03334ANPOtherARLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100422000283 AR Practitioner - Nurse Practitioner 6103953245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Arkansas College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

1215 Sidney St
Batesville, AR 72501-7202
Phone (870) 262-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03334ANPARMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
White River Health System, Inc. CurrentSince Apr 5, 2010 Accepting new patients
White River Health System, Inc. CurrentSince Apr 5, 2010 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1215 Sidney St
Ste 202
Batesville, AR 72501
Phone (870) 262-2000

16 Hospital Cir
Ste A
Batesville, AR 72501
Phone (870) 269-4361

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

Organizations & group practices 3

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1336462712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SIDNEY ST",
            "address_2": "SUITE 202",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017203",
            "telephone_number": "870-262-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 SIDNEY ST",
            "address_2": "SUITE 202",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017203",
            "telephone_number": "870-262-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "AMANDA",
        "middle_name": "S.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AR",
            "license": "A03334ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A03334ANP",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

Verify at the official NPI Registry.