Individual provider Active NPI

Amanda L NG, NP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1578233235
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30220 Issued in TN
Practice address
301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631
Phone
(423) 794-5590
Fax
(423) 794-5877
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30220 TN Primary
Nurse Practitioner 363L00000X 30220 TN

Addresses

Primary practice location

301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476
Phone (423) 794-5890

Other names 1

  • Amanda L Lundy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20211022001040 TN Practitioner - Nurse Practitioner 2961890090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

301 Med Tech Pkwy
Johnson City, TN 37604-2364
Phone (423) 794-5500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30220TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC CurrentSince Sep 23, 2021 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-6239

301 Med Tech Pkwy
Ste 120
Johnson City, TN 37604
Phone (423) 794-5590

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

4 Limited Centre St
Ste 103
Johnson City, TN 37604
Phone (423) 794-5890

1242 W Shipley Ferry Rd
Kingsport, TN 37663
Phone (423) 239-7300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1578233235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-794-5890",
            "fax_number": "423-794-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 120",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042631",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30220",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "30220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LUNDY",
            "middle_name": "L",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.