Active NPI
Amanda Mae Mann, APNP
- Nurse Practitioner
- Neenah, WI
National Provider Identifier
1508115379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4998-33
- Practice address
- 1516 S Commercial St
Neenah, WI 54956-4802 - Phone
- (920) 725-0077
- NPI assigned
- Sep 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4998-33 | WI | Primary |
Addresses
Primary practice location
1516 S Commercial St
Neenah, WI 54956-4802
Mailing address
7587 Evergreen Dr W
Waupaca, WI 54981-9643
Other names 1
- Amanda Mae Dallman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
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
Practice addresses (Care Compare)
1615 Maple LN
Ashland, WI 54806-3626
Phone (715) 682-5500
Hospital & facility affiliations
- Tamarack Health Ashland Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.19 of 100
- Quality
- 74.89
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4998-33 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Center Inc | Current | Accepting new patients | |
| Memorial Medical Center Inc | Current | Accepting new patients |
Locations
1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563
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.
-
- Critical Access Hospital
- Ashland, WI
- NPI 1437179231
-
- Rural Health Clinic/Center
- Ashland, WI
- NPI 1770255937
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Ashland, WI
- NPI 1437179231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346976000000",
"number": "1508115379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7587 EVERGREEN DR W",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549819643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 S COMMERCIAL ST",
"city": "NEENAH",
"state": "WI",
"postal_code": "549564802",
"telephone_number": "920-725-0077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "AMANDA",
"middle_name": "MAE",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-07",
"last_updated": "2012-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WI",
"license": "4998-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "DALLMAN",
"middle_name": "MAE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.