Individual provider Active NPI

Amanda Lawson, CPNP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1376972869
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013259 Issued in NC
Practice address
Pediatric Development & Behavior - Amos Cottage
3325 Silas Creek Parkway
Winston Salem, NC 27103-3013
Phone
(336) 713-4500
Fax
(336) 713-4501
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 5013259 NC
Nurse Practitioner 363L00000X 5013259 NC Primary

Addresses

Primary practice location

Pediatric Development & Behavior - Amos Cottage
3325 Silas Creek Parkway
Winston Salem, NC 27103-3013

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 713-0947

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
I20241113000123 NC Practitioner - Nurse Practitioner 0547492969 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Oct 7, 2024 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest Health Network LLC CurrentSince Oct 7, 2024 Accepting new patients

Locations

1 Trade St
Granite Falls, NC 28630
Phone (828) 396-3136

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: alawson2753607@carolinashealthcaresystem.direct-ci.com

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": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1376972869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-713-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEDIATRIC DEVELOPMENT & BEHAVIOR - AMOS COTTAGE",
            "address_2": "3325 SILAS CREEK PARKWAY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-713-4500",
            "fax_number": "336-713-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "AMANDA",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NC",
            "license": "5013259",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.