Amanda Soper

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

456879 Issued in NY

Practice address

211 JB Wise PL
Watertown, NY 13601-2507

Phone

(315) 782-7445

NPI assigned

Oct 25, 2023

Last updated

Oct 25, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Children's Home of Jefferson County

  • Community/Behavioral Health Agency
  • Watertown, NY
  • NPI 1538455696
  NPD
• Children's Home of Jefferson County

  • Case Management Agency
  • Watertown, NY
  • NPI 1770625527
  NPD

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1639941420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013102",
            "telephone_number": "315-782-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 JB WISE PL",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012507",
            "telephone_number": "315-782-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NY",
            "license": "456879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willenia C Smith
• Michele Lynn Smithers
• Ann Snell, R.N.
• Meagan Snyder
• Rose Mary Soosairaj, FNP
• Fakira Soumaila-Borkovec, FNP-C
• Kristen Leigh Sparks, M.S.
• Kelly Ann Spencer Ayen, COTA/L
• Nancy J Spicer, ANP
• Spinal Disc Regeneration Center

• Community Health Registered Nurse in Watertown, NY
• Providers in Watertown, NY by specialty
• Community Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.