Individual provider Active NPI

Amanda Lynn Dallas, APRN

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1447938600
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
34264 Issued in TN
Practice address
961 Spring Creek Rd
Chattanooga, TN 37412-3959
Phone
(423) 892-2221
NPI assigned
Jul 7, 2023
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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 34264 TN Primary

Addresses

Primary practice location

961 Spring Creek Rd
Chattanooga, TN 37412-3959

Mailing address

9223 Lakewood Cir
Soddy Daisy, TN 37379-3248
Phone (423) 994-7730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230829001141 TN Practitioner - Nurse Practitioner 8527421221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

961 Spring Creek Rd
Chattanooga, TN 37412-3959
Phone (423) 892-2221

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34264TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Family Practice Associates, P.C. CurrentSince Jul 24, 2023 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 4, 2024 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 4, 2024 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients

Locations

961 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 892-2221

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

Interoperability endpoints

  • Direct secure messaging: amanda.dallas.1@20785.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1447938600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9223 LAKEWOOD CIR",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373793248",
            "telephone_number": "423-994-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 SPRING CREEK RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123959",
            "telephone_number": "423-892-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "34264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.