Individual provider Active NPI

Amanda S Rennie, NP

  • Acute Care Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1598547408
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71014562A Issued in IN
Practice address
1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone
(812) 676-4300
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 28250897A IN
Nurse Practitioner 363L00000X 71014562A IN
Acute Care Nurse Practitioner 363LA2100X 71014562A IN Primary

Addresses

Primary practice location

1520 S Liberty Dr
Bloomington, IN 47403-5167

Mailing address

1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone (812) 676-4300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address arennie@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231129001196 IN Practitioner - Nurse Practitioner 6800244013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1520 S Liberty Dr
Indiana University So in Phy Inc
Bloomington, IN 47403-5167
Phone (888) 484-3258

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71014562AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Single Specialty CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Jan 14, 2024 Accepting new patients
Indiana University Health Southern Indiana Physicians Urology Registered Nurse Current Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Single Specialty CurrentSince Jan 14, 2024 Accepting new patients

Locations

1520 S Liberty Dr
Bloomington, IN 47403
Phone (812) 676-4300

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: arennie@direct.iuhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1598547408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035167",
            "telephone_number": "812-676-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035167",
            "telephone_number": "812-676-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNIE",
        "first_name": "AMANDA",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28250897A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014562A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71014562A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arennie@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1520 S Liberty Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474035167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.