Individual provider Active NPI

Amanda Brown Comer, N.P.

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1467616565
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26415 Issued in TN
Practice address
7715 Wolf River Blvd
Germantown, TN 38138-1706
Phone
(901) 328-6031
Fax
(901) 328-6035
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R867316 MS
Family Nurse Practitioner 363LF0000X 26415 TN Primary

Addresses

Primary practice location

7715 Wolf River Blvd
Germantown, TN 38138-1706

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

7736 Airways Blvd
Southaven, MS 38671-5306
Phone (662) 772-5222

Other names 1

  • Amanda Lee Brown Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081014000439 MS Practitioner - Nurse Practitioner 0345318606 Reassigns benefits to 2 organizations
I20230427000886 TN Practitioner - Nurse Practitioner 0345318606 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R867316MSMDFamily Nurse Practitioner
26415TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center CurrentSince Apr 1, 2017 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Medical Foundation of Central Mississippi, Inc. PastSince Mar 19, 2023 Accepting new patients

Locations

100 Hospital St
Ste 300
Booneville, MS 38829
Phone (601) 728-2147

100 Hospital St
#300
Booneville, MS 38829
Phone (662) 728-2147

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

703 Alcorn Dr
Ste 109
Corinth, MS 38834
Phone (662) 286-1499

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

7736 Airways Blvd
Southaven, MS 38671
Phone (662) 772-3700

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

7715 Wolf River Blvd
Memphis, TN 38138
Phone (901) 328-6031

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1467616565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "fax_number": "662-720-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7715 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381706",
            "telephone_number": "901-328-6031",
            "fax_number": "901-328-6035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7736 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715306",
            "country_code": "US",
            "telephone_number": "662-772-5222",
            "fax_number": "662-772-5957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMER",
        "first_name": "AMANDA",
        "middle_name": "BROWN",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867316",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BROWN",
            "middle_name": "LEE",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.