Amber Farris
Individual provider Active NPI Family Nurse Practitioner · Haleyville, AL
NPI 1396561957 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1396561957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1-108853 (AL)
- Practice address
- 1728 11TH Ave
Haleyville, AL 35565-1506 - Phone
- (205) 485-7822
- Fax
- (833) 449-4072
- NPI assigned
- Nov 28, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Revive Medical Center LLC
Practice addresses (Care Compare)
1728 11TH Ave
Haleyville, AL 35565-1506
Phone (205) 485-7822
Hospital & facility affiliations
- Russellville Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250418000233 | AL | Practitioner - Nurse Practitioner | 4183149503 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-108853 | AL | MD | General Practice Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Medical Center LLC | Current |
Accepting new patients | |
| NWMC-Winfield Physician Practices, LLC | Past |
Accepting new patients |
Locations
1728 11th Ave
Haleyville, AL 35565
Phone (205) 485-7822
Interoperability endpoints
- amber.farris.1@29882.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 1-108853 | AL | |
| Family Nurse Practitioner | 363LF0000X | 1-108853 | AL | Yes |
Addresses
Primary practice location
1728 11TH Ave
Haleyville, AL 35565-1506
Mailing address
1728 11TH Ave
Haleyville, AL 35565-1506
Phone (205) 485-7822
Other providers in Haleyville, AL
- David Carlos Elliott
- Robert M Ellis
- Encore Rehabilitation, Inc.
- Family Care First, Inc.
- Family Rehab Services, Inc
- Free State of Mind Psychiatry and Wellness LLC
- Freedom Family Dental PLLC
- Jane Ann D Gilbert
- Global Medical Equipment and Supplies
- Goar Pediatrics, PC
All providers in Haleyville, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.