Active NPI
Amanda J. Shields, ANP-PP
- Adult Health Nurse Practitioner
- Portland, OR
National Provider Identifier
1417026410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 200850093NP
- Practice address
- 5100 S Macadam Ave Ste 200
Portland, OR 97239-3827 - Phone
- (971) 202-5500
- Fax
- (971) 202-5555
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | APRN-220 | HI | |
| Adult Health Nurse Practitioner | 363LA2200X | 200850093NP | OR | Primary |
Addresses
Primary practice location
5100 S Macadam Ave Ste 200
Portland, OR 97239-3827
Mailing address
5100 S Macadam Ave Ste 200
Portland, OR 97239-3827
Phone (971) 202-5500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A0220317 | Other | HI | HMSA |
| 5019444 | Other | HI | UHA |
| 550196 02 | Medicaid | HI |
Other names 1
- Ms. Amanda J Thomson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Columbia Lutheran Charities
Practice addresses (Care Compare)
1639 SE Ensign LN
Warrenton, OR 97146-7308
Phone (503) 338-4500
Hospital & facility affiliations
- Providence Home Health
- Columbia Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220 | HI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Lutheran Charities | Current | Accepting new patients | |
| Columbia Lutheran Charities | Current | Accepting new patients | |
| Columbia Lutheran Charities | Past | Accepting new patients | |
| Columbia Lutheran Charities | Past | Accepting new patients |
Locations
2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321
Interoperability endpoints
- amandashields@hpi.allscriptsdirect.net
Organizations & group practices 5
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.
-
- Critical Access Hospital
- Astoria, OR
- NPI 1134146939
-
- Surgery Physician
- Astoria, OR
- NPI 1821254129
-
- Community Based Hospice Care Agency
- Astoria, OR
- NPI 1023038858
-
- Critical Access Hospital
- Astoria, OR
- NPI 1932814704
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Astoria, OR
- NPI 1134146939
-
- Critical Access Hospital
- Astoria, OR
- NPI 1700809761
-
- Home Health Agency
- Portland, OR
- NPI 1790873461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638835200000",
"number": "1417026410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 S MACADAM AVE STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393827",
"telephone_number": "971-202-5500",
"fax_number": "971-202-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 S MACADAM AVE STE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393827",
"telephone_number": "971-202-5500",
"fax_number": "971-202-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "AMANDA",
"middle_name": "J.",
"name_prefix": "Ms.",
"credential": "ANP-PP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2021-12-07",
"certification_date": "2021-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "HI",
"license": "APRN-220",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OR",
"license": "200850093NP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "00A0220317",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHA",
"identifier": "5019444",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "550196 02",
"state": "HI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "THOMSON",
"middle_name": "J",
"prefix": "MS.",
"credential": "ANP-PP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.