Amanda Jutras

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

33U8W Issued in NC

Practice address

113 Doctors Park
Lincolnton, NC 28092-4407

Phone

(704) 735-1441

Fax

(704) 735-1472

NPI assigned

Jul 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lincoln Pediatrics Clinic,PA

  • Specialist
  • Lincolnton, NC
  • NPI 1477510659
  NPD (past)

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1639740384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 HAMPTON RD",
            "city": "POMFRET CENTER",
            "state": "CT",
            "postal_code": "062592017",
            "telephone_number": "860-539-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 DOCTORS PARK",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280924407",
            "telephone_number": "704-735-1441",
            "fax_number": "704-735-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUTRAS",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NC",
            "license": "349451",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "33U8W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "address_1": "115 Spencer St",
            "city": "Winsted",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060981140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jonathan C Austin DMD PA
• Karen Jones
• Derrick Lamont Jordan
• Mackenzie Lowman Jordan
• Kathryn Jennette Journigan-Douglas, MSW, LCSW
• Arundeep Singh Kahlon, MD
• Keever Pharmacy , LLC
• Keever Pharmacy , LLC
• Ann Willis Keever
• Devin Kathleen Kemmy, FNP

• Pediatric Nurse Practitioner in Lincolnton, NC
• Providers in Lincolnton, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.