Individual provider Active NPI

Amanda Lee Welch, CPNP

  • Pediatric Nurse Practitioner
  • Midland, TX
National Provider Identifier
1629736491
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1059611 Issued in TX
Practice address
5801 W Wadley Ave
Midland, TX 79707-5055
Phone
(432) 699-2636
NPI assigned
Nov 29, 2021
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1059611 TX Primary

Addresses

Primary practice location

5801 W Wadley Ave
Midland, TX 79707-5055

Mailing address

5801 W Wadley Ave
Midland, TX 79707-5055
Phone (432) 699-2636

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL laptop

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
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1059611TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra Maerzacker, MD, PLLC Pediatrics CurrentSince Nov 26, 2023 Accepting new patients
Sari Nabulsi MD LTD LLP Pediatrics PastSince Dec 5, 2021 Accepting new patients

Locations

5801 W Wadley Ave
Midland, TX 79707
Phone (432) 699-2636

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1629736491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075055",
            "telephone_number": "432-699-2636",
            "fax_number": "432-699-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075055",
            "telephone_number": "432-699-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1059611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "address_1": "5801 W Wadley Ave",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797075055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.