Individual provider Active NPI

Amanda Woodward

  • Family Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1467077990
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN206584 Issued in GA
Practice address
775 Poplar Rd Ste 310
Newnan, GA 30265-8303
Phone
(770) 251-2590
Fax
(770) 251-1490
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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 RN206584 GA Primary

Addresses

Primary practice location

775 Poplar Rd Ste 310
Newnan, GA 30265-8303

Mailing address

1800 Howell Mill Rd NW Ste 800
Atlanta, GA 30318-0922
Phone (770) 251-2590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200706001027 GA Practitioner - Nurse Practitioner 2769805092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Piedmont Cancer Institute PCGroup PAC ID 9638167844, 43 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W
Suite 4200
Fayetteville, GA 30214-2112
Phone (678) 829-1060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cancer Institute PC CurrentSince Jun 15, 2020 Accepting new patients
Piedmont Cancer Institute PC CurrentSince Jun 15, 2020 Accepting new patients

Locations

1800 Howell Mill Rd NW
Ste 800
Atlanta, GA 30318
Phone (404) 350-9853

1800 Howell Mill Rd NW
Ste 575
Atlanta, GA 30318

1267 Highway 54 W
Ste 4200
Fayetteville, GA 30214
Phone (678) 829-1060

775 Poplar Rd
Ste 310
Newnan, GA 30265
Phone (770) 251-2590

1240 Eagles Landing Pkwy
Ste 260
Stockbridge, GA 30281
Phone (678) 854-9500

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1467077990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW STE 800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303180922",
            "telephone_number": "770-251-2590",
            "fax_number": "770-251-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD STE 310",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658303",
            "telephone_number": "770-251-2590",
            "fax_number": "770-251-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN206584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.