Amanda Sue Wilson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2012033367 Issued in MO

Practice address

2820 E Rock Haven Rd
Ste. 100
Harrisonville, MO 64701-4411

Phone

(816) 380-3582

Fax

(816) 380-6964

NPI assigned

Sep 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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

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.

• Olathe Health Physicians, Inc.

  • Family Medicine Physician
  • Olathe, KS
  • NPI 1598784639
  Medicare reassignment

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1356692701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 E ROCK HAVEN RD",
            "address_2": "STE. 100",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647014411",
            "telephone_number": "816-380-3582",
            "fax_number": "816-380-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 E ROCK HAVEN RD",
            "address_2": "STE. 100",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647014411",
            "telephone_number": "816-380-3582",
            "fax_number": "816-380-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012033367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356692701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynette Wescoat, PHARMD
• Westchester Family Care PC
• Andrea Whalen
• Elizabeth A Williamson, PHARMD
• Willow Brooke Homes
• Marlene Wilson
• Crystal Dawn Wise, FNP
• Roger P. Wise, PSY.D.
• Mary Woods, LPC
• Ashlee Nichole Worthey, PHARM.D.

• Family Nurse Practitioner in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.