Amanda Kathryn Dolega, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.16603-NP Issued in OH

Practice address

1 CVS Dr
Woonsocket, RI 02895-6195

Phone

(401) 765-1500

NPI assigned

Nov 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 11

Addresses

Other names 1

• Amanda Kathryn Detore Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Ohio LLCGroup PAC ID 2961425608, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Minuteclinic Diagnostic of Ohio LLC

  • Family Nurse Practitioner
  • Hilliard, OH
  • NPI 1699747303
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care Ohio LLC

  • Family Nurse Practitioner
  • Hilliard, OH
  • NPI 1285441766
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1518364041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11706 CLIFTON BLVD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072018",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956195",
            "telephone_number": "401-765-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39350 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481679164",
            "country_code": "US",
            "telephone_number": "248-735-6081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1855 Gattis School Rd",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786647428",
            "country_code": "US",
            "telephone_number": "512-238-6268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28100 Chagrin Blvd",
            "address_2": "CVS Minute Clinic",
            "address_purpose": "LOCATION",
            "city": "Woodmere",
            "state": "OH",
            "postal_code": "441224522",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 E Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891194547",
            "country_code": "US",
            "telephone_number": "702-361-6581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 S Claiborne Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701255105",
            "country_code": "US",
            "telephone_number": "504-891-7737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5566 S 56th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685161834",
            "country_code": "US",
            "telephone_number": "402-423-3839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLEGA",
        "first_name": "AMANDA",
        "middle_name": "KATHRYN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1231687",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A190460",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "239489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "117197",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "248830",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "4681924",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0107483-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "904535",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704452868",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.16603-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "APRN-CNP59844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "DETORE",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith M Dixon, FNPC
• Erin E. Doak, LCSW
• Kristen Nicole Dobbs
• Jeffrey Edward Dodge I, D.M.D.
• Charity Dolan, PEER RERCOVERY SPECI
• Erwin Joseph Domingo, D.D.S.
• Glenn Legaspi Dominguez, DMD
• Patricia Donahue
• Britney Donnelly, MS CCC-SLP
• Cheryl M Donovan, CNM

• Family Nurse Practitioner in Woonsocket, RI
• Providers in Woonsocket, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.

Verify at the official NPI Registry.