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Individual provider Active NPI

Amanda Dustin, APRN

  • Family Nurse Practitioner
  • Berlin, NH
National Provider Identifier
1497002174
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
06146123 Issued in NH
Practice address
59 Page Hill Rd
Berlin, NH 03570-3531
Phone
(603) 752-2900
NPI assigned
Aug 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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 06146123 NH Primary

Addresses

Primary practice location

59 Page Hill Rd
Berlin, NH 03570-3531

Mailing address

133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040

Other identifiers 1

IdentifierTypeStateIssuer
06146123OtherNHLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121030000388 NH Practitioner - Nurse Practitioner 5597915439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coos County Family Health Services IncGroup PAC ID 8628970480, 33 clinicians

Practice addresses (Care Compare)

59 Page Hill Rd
Berlin, NH 03570-3531
Phone (603) 752-2900

Hospital & facility affiliations

  • North Country Home Health & Hospice Agency Home health agency, Littleton, NH, CCN 307009
  • Androscoggin Valley Hospital Hospital, Berlin, NH, CCN 301310
  • Coos County Nursing Home Nursing home, Berlin, NH, CCN 305102
  • Saint Vincent Rehabilitation & Nursing Center Nursing home, Berlin, NH, CCN 305066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06146123NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coos County Family Health Services, Inc CurrentSince Aug 13, 2012 Accepting new patients
Coos County Family Health Services, Inc CurrentSince Aug 13, 2012 Accepting new patients
Coos County Nursing Home Past Accepting new patients
Coos County Family Health Services, Inc Family Past Accepting new patients
St Vincent Rehabilitation & Nursing Center Past Accepting new patients

Locations

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

133 Pleasant St
Berlin, NH 03570
Phone (603) 752-2040

6 1st St
Colebrook, NH 03576
Phone (603) 237-4262

2 Broadway Ave
Gorham, NH 03581
Phone (603) 466-2741

Organizations & group practices 7

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 6

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": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1497002174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLEASANT ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702006",
            "telephone_number": "603-752-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PAGE HILL RD",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035703531",
            "telephone_number": "603-752-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSTIN",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "06146123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "06146123",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NH

Sources for this page

Verify at the official NPI Registry.