Individual provider Active NPI

Amanda J Williams, CNP

  • Nurse Practitioner
  • Portsmouth, OH
National Provider Identifier
1639692759
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.021744 Issued in OH
Practice address
1711 27TH St Ste 206
Portsmouth, OH 45662-2669
Phone
(740) 356-8772
Fax
(740) 356-1264
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.021744 OH Primary

Addresses

Primary practice location

1711 27TH St Ste 206
Portsmouth, OH 45662-2669

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-7942

Other identifiers 1

IdentifierTypeStateIssuer
0243719MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amanda.williams@somc.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20171005000606 OH Practitioner - Nurse Practitioner 1254606916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8117

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. Nurse Practitioner CurrentSince Oct 9, 2017 Accepting new patients
Somc Medical Care Foundation, Inc. CurrentSince Oct 9, 2017 Accepting new patients

Locations

1711 27th St
Ste 206
Portsmouth, OH 45662
Phone (740) 356-8772

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1711 27th St
Portsmouth, OH 45662
Phone (740) 352-1175

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1639692759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-7942",
            "fax_number": "740-356-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 27TH ST STE 206",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622669",
            "telephone_number": "740-356-8772",
            "fax_number": "740-356-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.021744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243719",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.williams@somc.medicity.net",
            "affiliation": "N",
            "address_1": "1711 27th St Ste 206",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456622669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.