Individual provider Active NPI

Amanda J. Duch, APN

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1619049384
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A01202 Issued in AR
Practice address
1150 E. Matthews
Suite 101
Jonesboro, AR 72401
Phone
(870) 972-5437
Fax
(870) 972-0104
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A01202 AR Primary

Addresses

Primary practice location

1150 E. Matthews
Suite 101
Jonesboro, AR 72401

Mailing address

PO Box 1960
Jonesboro, AR 72403-1960
Phone (870) 934-5102

Other identifiers 1

IdentifierTypeStateIssuer
132458758MedicaidAR

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A01202ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of Jonesboro, PLLC Past Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FECIAD/Endpoint/FECIAD

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1619049384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031960",
            "telephone_number": "870-934-5102",
            "fax_number": "870-932-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E. MATTHEWS",
            "address_2": "SUITE 101",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-972-5437",
            "fax_number": "870-972-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCH",
        "first_name": "AMANDA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132458758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.