Individual provider Active NPI

Amanda Leigh Moody, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1417626268
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5015000 Issued in NC
Practice address
3000 Highwoods Blvd Ste 310
Raleigh, NC 27604-1029
Phone
(919) 714-7500
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 00000000 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5015000 NC Primary

Addresses

Primary practice location

3000 Highwoods Blvd Ste 310
Raleigh, NC 27604-1029

Mailing address

13137 Bold Run Hill Rd
Wake Forest, NC 27587-7800
Phone (919) 691-5995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241220002728 NC Practitioner - Nurse Practitioner 6507393154 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000000NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alamance Regional Medical Center, Inc CurrentSince Jan 26, 2025 Accepting new patients
Alamance Regional Medical Center, Inc. Single Specialty CurrentSince Jan 26, 2025 Accepting new patients
Hope Services, LLC Single Specialty CurrentSince Sep 12, 2021 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Single Specialty Current Accepting new patients
Hope Services, LLC PastSince Sep 12, 2021 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

700 Walter Reed Dr
Greensboro, NC 27403
Phone (336) 832-9600

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

931 3rd St
Greensboro, NC 27405
Phone (336) 890-2700

300 E Wendover Ave
Fl 2
Greensboro, NC 27401
Phone (336) 663-5219

3000 Highwoods Blvd
Ste 310
Raleigh, NC 27604
Phone (919) 714-7500

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.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1417626268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13137 BOLD RUN HILL RD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877800",
            "telephone_number": "919-691-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HIGHWOODS BLVD STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041029",
            "telephone_number": "919-714-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "00000000",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5015000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.