Individual provider Active NPI

Amanda Marie Fletcher, FNP-C

  • Family Nurse Practitioner
  • Robins Afb, GA
National Provider Identifier
1396375671
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0995686-NP Issued in CO
Practice address
655 7TH St
Robins Afb, GA 31098-2227
Phone
(478) 327-8487
NPI assigned
Jan 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Obstetric Registered Nurse 163WX0003X 1653323 CO
Family Nurse Practitioner 363LF0000X APN.0995686-NP CO Primary

Addresses

Primary practice location

655 7TH St
Robins Afb, GA 31098-2227

Mailing address

655 7TH St
Robins Afb, GA 31098-2227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20200723000335 CO Practitioner - Nurse Practitioner 1658795612 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1653323COMDInpatient Obstetric Registered Nurse
APN.0995686-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Colorado, LLC Family CurrentSince Jul 17, 2020 Accepting new patients

Locations

1750 W Uintah St
Colorado Springs, CO 80904
Phone (719) 325-0344

7984 W Alameda Ave
Lakewood, CO 80226
Phone (303) 459-7105

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1396375671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 7TH ST",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 7TH ST",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227",
            "telephone_number": "478-327-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-25",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "CO",
            "license": "1653323",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0995686-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robins Afb, GA

Sources for this page

Verify at the official NPI Registry.