Amanda Lea Keough, APRN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2360670 Issued in MN

Practice address

1101 9TH St N
Virginia, MN 55792-2329

Phone

(218) 741-0150

NPI assigned

Jan 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Amanda Lea Drake Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aveanna Home Health Home health agency, Hibbing, MN, CCN 247218
• Essentia Health Virginia Hospital, Virginia, MN, CCN 240084
• Essentia Health Northern Pines Medical Center Hospital, Aurora, MN, CCN 241340

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Virginia, MN
  • NPI 1457387441
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• The Duluth Clinic, LTD

  • Anesthesiology Physician
  • Duluth, MN
  • NPI 1760417935
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Essentia Health Virginia, LLC

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Care Compare affiliation
• Northern Pines Medical Center

  • Critical Access Hospital
  • Aurora, MN
  • NPI 1639278609
  Care Compare affiliation
• Northern Pines Medical Center

  • Critical Access Hospital Clinic/Center
  • Aurora, MN
  • NPI 1881954147
  Care Compare affiliation
• Recover Health of Minnesota, Inc.

  • Home Health Agency
  • Virginia, MN
  • NPI 1598768350
  Care Compare affiliation

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1407507411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922329",
            "telephone_number": "218-741-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOUGH",
        "first_name": "AMANDA",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2360670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DRAKE",
            "middle_name": "LEA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JP Companies of Virginia Inc
• Stefan Leroy Kaiser, MD
• Jayden L Karppinen
• Kathleen Sulentich MD Facog LTD
• Joan V Kaurala
• Christine F Ketelsen, MSW LICSW
• Showkat Hayat Khan
• Brandi Lynn Kilbourn, OT
• Karlie J Kintner
• Jason E Kirk

• Family Nurse Practitioner in Virginia, MN
• Providers in Virginia, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.