Individual provider Active NPI

Amanda L Tomes, AGCNS-BC

  • Clinical Nurse Specialist
  • Grand Rapids, MI
National Provider Identifier
1609480219
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
4704313257 Issued in MI
Practice address
230 Michigan St NE
Grand Rapids, MI 49503-2550
Phone
(616) 267-0770
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 4704313257 MI Primary

Addresses

Primary practice location

230 Michigan St NE
Grand Rapids, MI 49503-2550

Mailing address

6057 8TH Ave SW Apt 1a
Grandville, MI 49418-9465
Phone (616) 848-6137

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

LicenseStateTypeSpecialty
4704313257MIMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1609480219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6057 8TH AVE SW APT 1A",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494189465",
            "telephone_number": "616-848-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032550",
            "telephone_number": "616-267-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMES",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "AGCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MI",
            "license": "4704313257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.