Active NPI
Amanda Lyn Vandenburg, APRN-CNP
- Nurse Practitioner
- Boswell, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 73707
- Practice address
- 415 6TH Street
Boswell, OK 74727-0000 - Phone
- (580) 566-2530
- Fax
- (580) 566-2533
- NPI assigned
- Oct 26, 2015
- Last updated
- Nov 12, 2025
- 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 | 73707 | OK | Primary |
Addresses
Primary practice location
415 6TH Street
Boswell, OK 74727-0000
Mailing address
PO Box 219
Clayton, OK 74536-0219
Phone (918) 917-9999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- 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, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
415 6TH St
Boswell, OK 74727-2072
Phone (580) 566-2530
PO Box
Suite 219
Clayton, OK 74536
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pushmataha Family Medical Center Inc | Current | Accepting new patients | |
| Pushmataha Family Medical Center, Inc | Current | Accepting new patients | |
| Essent PRMC LP | Past | Accepting new patients |
Locations
415 6th St
Boswell, OK 74727
Phone (580) 566-2530
Interoperability endpoints
- amanda.vandenburg@pfmcok.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/GEIDAA
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Pushmataha Family Medical Center of Boswell | Federally qualified health center | Corporate Director | Feb 23, 2023 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Pushmataha Family Medical Center of Boswell
- Federally Qualified Health Center (FQHC)
- Boswell, OK
- NPI 1487193819
Corporate Director
-
- Federally Qualified Health Center (FQHC)
- Clayton, OK
- NPI 1891882676
Corporate Director
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Clayton, OK
- NPI 1891882676
-
dba Pushmataha Family Medical Center of Boswell
- Federally Qualified Health Center (FQHC)
- Boswell, OK
- NPI 1487193819
-
dba Paris Regional Medical Center
- General Acute Care Hospital
- Paris, TX
- NPI 1063411767
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Enhabit Home Health of Southeast Oklahoma
- Home Health Agency
- Hugo, OK
- NPI 1588644843
-
dba Paris Regional Medical Center
- General Acute Care Hospital
- Paris, TX
- NPI 1063411767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762905600000",
"number": "1528430998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 219",
"city": "CLAYTON",
"state": "OK",
"postal_code": "745360219",
"telephone_number": "918-917-9999",
"fax_number": "918-569-7552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 6TH STREET",
"city": "BOSWELL",
"state": "OK",
"postal_code": "747270000",
"telephone_number": "580-566-2530",
"fax_number": "580-566-2533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBURG",
"first_name": "AMANDA",
"middle_name": "LYN",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2025-11-12",
"certification_date": "2025-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "73707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boswell, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.