Individual provider Active NPI

Amanda Nichole Korte, N.P.

  • Family Nurse Practitioner
  • Breese, IL
National Provider Identifier
1396087599
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20901339 Issued in IL
Practice address
9423 Holy Cross LN
Suite 111
Breese, IL 62230-3510
Phone
(618) 526-8850
Fax
(618) 526-8852
NPI assigned
Mar 26, 2013
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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 20901339 IL Primary

Addresses

Primary practice location

9423 Holy Cross LN
Suite 111
Breese, IL 62230-3510

Mailing address

1504 19TH St
Highland, IL 62249-2547
Phone (618) 779-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20141023001333 IL Practitioner - Nurse Practitioner 7719108380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20901339ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Right From the Start Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1396087599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 19TH ST",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492547",
            "telephone_number": "618-779-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9423 HOLY CROSS LN",
            "address_2": "SUITE 111",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303510",
            "telephone_number": "618-526-8850",
            "fax_number": "618-526-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTE",
        "first_name": "AMANDA",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "20901339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breese, IL

Sources for this page

Verify at the official NPI Registry.