Individual provider Active NPI

Amanda Nicole Collins

  • Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1366915985
Registry record updated Jul 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
253269 Issued in NC
Practice address
2525 Court Dr
Gastonia, NC 28054-2140
Phone
(704) 834-2000
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 253269 NC Primary

Addresses

Primary practice location

2525 Court Dr
Gastonia, NC 28054-2140

Mailing address

7294 Oxford Bluff Dr
Stanley, NC 28164-6812
Phone (704) 308-2858

Other practice location 1

7294 Oxford Bluff Dr
Stanley, NC 28164-6812
Phone (704) 308-2858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190916000723 NC Practitioner - Nurse Practitioner 7012246176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastonia Physician Services PLLCGroup PAC ID 3870719602, 66 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2000

Merit-based Incentive Payment System (MIPS)

Final score
91.82 of 100Reported as group
Quality
84.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gastonia Physician Services, PLLC CurrentSince Jul 1, 2019 Accepting new patients
Gastonia Physician Services, PLLC Current Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562371200000",
    "number": "1366915985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7294 OXFORD BLUFF DR",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "281646812",
            "telephone_number": "704-308-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "704-834-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7294 Oxford Bluff Dr",
            "address_purpose": "LOCATION",
            "city": "Stanley",
            "state": "NC",
            "postal_code": "281646812",
            "country_code": "US",
            "telephone_number": "704-308-2858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "253269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.