Amanda Jene Wirth, APRN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

APRN9482070 Issued in FL

Practice address

215 Imperial Blvd Ste B2
Lakeland, FL 33803-4689

Phone

(813) 684-2229

Fax

(813) 413-8507

NPI assigned

Sep 30, 2014

Last updated

Jan 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Hospital Physician Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OH

  Medicare reassignment NPD
• Florida Department of Health

  dba Levy County Health Department

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD
• Florida Department of Health

  dba Florida Department of Health in Polk County

  • Public Health or Welfare Agency
  • Lakeland, FL
  • NPI 1396732541
  NPD
• Florida Woman Care LLC

  • Obstetrics & Gynecology Physician
  • Deltona, FL
  • NPI 1174199780
  NPD
• Womens Care Florida LLP

  • Obstetrics & Gynecology Physician
  • Orlando, FL
  • NPI 1013153030
  NPD (past)
• Womens Care Florida LLP

  • Obstetrics & Gynecology Physician
  • Oviedo, FL
  • NPI 1275779290
  NPD (past)
• Womens Care Florida LLP

  • Obstetrics & Gynecology Physician
  • Orlando, FL
  • NPI 1558507574
  NPD (past)
• Allara Medical Group PA

  • Gynecology Physician
  • New York, NY
  • NPI 1700450558
  NPD (past)

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1619370053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 IMPERIAL BLVD STE B2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034689",
            "telephone_number": "813-684-2229",
            "fax_number": "813-413-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 IMPERIAL BLVD STE B2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034689",
            "telephone_number": "813-684-2229",
            "fax_number": "813-413-8507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 W Broadway St",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327656456",
            "country_code": "US",
            "telephone_number": "407-366-9195",
            "fax_number": "407-898-9944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Park Center Dr Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328355794",
            "country_code": "US",
            "telephone_number": "407-296-8044",
            "fax_number": "407-898-9944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "785 Primera Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "32746",
            "country_code": "US",
            "telephone_number": "407-834-8111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "785 Primera Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "32746",
            "country_code": "US",
            "telephone_number": "407-834-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "AMANDA",
        "middle_name": "JENE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "16289",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "APRN9482070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024693700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111806",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret P Wimberly, ARNP
• Brian Win, PA
• Winn-Ful Grace Homecare Service Inc
• Ann Chacko Winny, MD
• Natalie Anne Wipert, APRN
• Georgia Frances Wise, LCSW
• Heather Ann Wise
• Sara Lindsay Wise, FNP
• Shelby Witherspoon
• Jessica Nicole Withrow, CRNA

• Women's Health Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Women's Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.