Active NPI
Amanda Mummery
- Pediatric Nurse Practitioner
- King of Prussia, PA
National Provider Identifier
1558094052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- SP026192
- Practice address
- Children'S Hospital of Philadelphia
550 South Goddard Blvd
King of Prussia, PA 19406 - Phone
- (646) 812-3870
- NPI assigned
- Jul 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 172417 | CT | |
| Pediatric Nurse Practitioner | 363LP0200X | SP026192 | PA | Primary |
Addresses
Primary practice location
Children'S Hospital of Philadelphia
550 South Goddard Blvd
King of Prussia, PA 19406
Mailing address
4701 Pine St Apt F11
Philadelphia, PA 19143-7009
Phone (646) 812-3870
Other practice location 1
282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | mummerya@chop.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172417 | CT | MD | Registered Nurse |
| SP026192 | PA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1558094052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 PINE ST APT F11",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191437009",
"telephone_number": "646-812-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
"address_2": "550 SOUTH GODDARD BLVD",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "19406",
"telephone_number": "646-812-3870"
}
],
"practiceLocations": [
{
"address_1": "282 Washington St",
"address_purpose": "LOCATION",
"city": "Hartford",
"state": "CT",
"postal_code": "061063322",
"country_code": "US",
"telephone_number": "860-545-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUMMERY",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-03",
"last_updated": "2022-10-26",
"certification_date": "2022-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "172417",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP026192",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "mummerya@chop.edu",
"affiliation": "N",
"address_1": "Children's Hospital of Philadelphia",
"address_2": "550 South Goddard Blvd",
"city": "King of Prussia",
"state": "PA",
"country_code": "US",
"postal_code": "19406",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.