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Individual provider Active NPI

Amanda Louise Osborne, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1346548096
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R865995 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 268-5700
Fax
(601) 268-5777
NPI assigned
Mar 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R865995 MS Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20110503000573 MS Practitioner - Nurse Practitioner 0446435606 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Mississippi Nephrology, PLLCGroup PAC ID 8628069408, 10 clinicians

Practice addresses (Care Compare)

4300 B W Railroad St
Gulfport, MS 39501-2568
Phone (228) 863-5705

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Ochsner Medical Center-Hancock Hospital, Bay Saint Louis, MS, CCN 250162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R865995MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Family Health Center Inc CurrentSince Apr 9, 2018 Accepting new patients
South Mississippi Nephrology, PLLC CurrentSince Sep 15, 2022 Accepting new patients
Care Doc LLC CurrentSince Apr 15, 2023 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jan 13, 2020 Accepting new patients
Coastal Family Health Center, Inc Current Accepting new patients
Caredoc LLC CurrentSince Apr 15, 2023 Accepting new patients
Coastal Family Health Center, Inc CurrentSince Apr 9, 2018 Accepting new patients

Locations

1046 Division St
Biloxi, MS 39530
Phone (225) 374-2494

4300 Leisure Time Dr
Diamondhead, MS 39525
Phone (228) 255-4300

4300 W Railroad St
#B
Gulfport, MS 39501
Phone (228) 864-0854

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4300B W Railroad St
Gulfport, MS 39501
Phone (228) 863-5705

15024 Mlk
Gulfport, MS 39501
Phone (228) 846-0003

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Organizations & group practices 9

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 62

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

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1346548096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5700",
            "fax_number": "601-268-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5700",
            "fax_number": "601-268-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "AMANDA",
        "middle_name": "LOUISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R865995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.