Individual provider Active NPI

Amanda R. Owen, ARNP

  • Pediatric Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1518158286
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3005248 Issued in KY
Practice address
1301 Ring Rd
Elizabethtown, KY 42701-8968
Phone
(270) 765-2107
Fax
(270) 769-9642
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3005248 KY
Pediatric Nurse Practitioner 363LP0200X 3005248 KY Primary

Addresses

Primary practice location

1301 Ring Rd
Elizabethtown, KY 42701-8968

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Other practice location 1

1207 Woodland Dr
Elizabethtown, KY 42701-2709
Phone (270) 765-2107

Other identifiers 9

IdentifierTypeStateIssuer
50016143OtherKYPASSPORT - CMA
1567385OtherKYFIRST HEALTH - CMA
000000534238OtherKYANTHEM - CMA
2861862000OtherKYPASSPORT ADVTG - CMA
7100014560MedicaidKY
000023028WOtherKYHUMANA - CMA
300056675MedicaidIN
K132010OtherKYMEDICARE
093346OtherKYSIHO - CMA

Other names 1

  • Amanda R. Lancaster Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aowen5519@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20071008000242 KY Practitioner - Nurse Practitioner 4183719065 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Aug 6, 2007 Accepting new patients
Norton Childrens Medical Group, LLC Nurse Practitioner CurrentSince Dec 19, 2020 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Aug 6, 2007 Accepting new patients
Norton Children's Medical Group, LLC Nurse Practitioner CurrentSince Dec 19, 2020 Accepting new patients

Locations

1301 Ring Rd
Elizabethtown, KY 42701
Phone (270) 765-2107

1207 Woodland Dr
Elizabethtown, KY 42701
Phone (270) 765-2107

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: aowen5519@direct.nortonhealthcare.org

Organizations & group practices 6

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1518158286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018968",
            "telephone_number": "270-765-2107",
            "fax_number": "270-769-9642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 Woodland Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012709",
            "country_code": "US",
            "telephone_number": "270-765-2107",
            "fax_number": "270-769-9642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "AMANDA",
        "middle_name": "R.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3005248",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3005248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT - CMA",
            "identifier": "50016143",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH - CMA",
            "identifier": "1567385",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - CMA",
            "identifier": "000000534238",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVTG - CMA",
            "identifier": "2861862000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100014560",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - CMA",
            "identifier": "000023028W",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300056675",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K132010",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO - CMA",
            "identifier": "093346",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aowen5519@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "1207 Woodland Dr",
            "city": "Elizabethtown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427012709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "1207 Woodland Dr",
            "city": "Elizabethtown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427012709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LANCASTER",
            "middle_name": "R.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.