Individual provider Active NPI

Amanda K Del Valle, ARNP-C,FNP

  • Family Nurse Practitioner
  • Lawrence, KS
National Provider Identifier
1407989809
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
45651 Issued in KS
Practice address
1130 W 4TH St Ste 2050
Lawrence, KS 66044-1333
Phone
(785) 505-3636
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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 45651 KS Primary

Addresses

Primary practice location

1130 W 4TH St Ste 2050
Lawrence, KS 66044-1333

Mailing address

1130 W 4TH St Ste 2050
Lawrence, KS 66044-1333
Phone (785) 505-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20200717000474 KS Practitioner - Nurse Practitioner 8022333202 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Physicians LLC CurrentSince Jul 1, 2020 Accepting new patients
Lawrence Physicians LLC Current Accepting new patients
Lawrence Physicians LLC CurrentSince Jul 1, 2020 Accepting new patients
The Internal Medicine Group PA Past Accepting new patients

Locations

1130 W 4th St
Ste 2050
Lawrence, KS 66044
Phone (785) 505-3636

325 Maine St
Lawrence, KS 66044
Phone (785) 505-2988

Interoperability endpoints

  • Direct secure messaging: amanda.delvalle1@direct.lmh.org

Organizations & group practices 4

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1407989809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 W 4TH ST STE 2050",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441333",
            "telephone_number": "785-505-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 W 4TH ST STE 2050",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441333",
            "telephone_number": "785-505-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL VALLE",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "ARNP-C,FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "45651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.