Amanda Nicole Hanson, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R875468 Issued in MS

Practice address

6510 Highway 90 Ste a
Gautier, MS 39553-5015

Phone

(228) 822-6148

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahanson@direct.mhg.com

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.

• Coastal Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Biloxi, MS
  • NPI 1629066782
  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment
• Coastal Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lucedale, MS
  • NPI 1427842913
  NPD
• Coastal Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Moss Point, MS
  • NPI 1679581599
  NPD
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  NPD (past)

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1619214541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 HIGHWAY 90 STE A",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535015",
            "telephone_number": "228-822-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 HIGHWAY 90 STE A",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535015",
            "telephone_number": "228-822-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R875468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087588233",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "385845YSCQ",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Halstead
• Lori Rebecca Hancock, B.A.
• Hands of Angels Phlebotomy School and Mobile Services LLC
• Hanger Prosthetics & Orthotics Inc
• Nathaniel Louis George Hanley, BS
• Vedriann Marissa Harden, MA
• Jefferson Hopkins Harman Jr., M.D.
• Danyelle Harris
• Sierra Harris
• Angela Powell Harrison, BS

• Family Nurse Practitioner in Gautier, MS
• Providers in Gautier, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.