Individual provider Active NPI

Amanda J Musselman, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1649361197
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11027973 Issued in FL
Practice address
1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone
(772) 468-4551
NPI assigned
Sep 28, 2006
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN9309351 FL
Other Technician 247200000X
Family Nurse Practitioner 363LF0000X APRN11027973 FL Primary

Addresses

Primary practice location

1700 S 23Rd St
Fort Pierce, FL 34950-4803

Mailing address

1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone (772) 468-4551

Other practice location 1

14750 NW 44th Ct
Opa Locka, FL 33054-2304
Phone (305) 953-2266

Other practice location 2

2504 Acorn St Ste A
Fort Pierce, FL 34947-4746
Phone (772) 837-7800

Other names 1

  • Amanda Jean Earnest Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250106000577 FL Practitioner - Nurse Practitioner 8527596592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Lawnwood Regional Medical Center
Fort Pierce, FL 34950-4899
Phone (772) 461-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9309351FLMDEmergency Registered Nurse
APRN11027973FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC CurrentSince Sep 23, 2024 Accepting new patients
Hospital Medicine Services of FL, LLC CurrentSince Sep 23, 2024 Accepting new patients
Grace Wellness Center LLC Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 3

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.

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1649361197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S 23RD ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504803",
            "telephone_number": "772-468-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S 23RD ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504803",
            "telephone_number": "772-468-4551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14750 NW 44th Ct",
            "address_purpose": "LOCATION",
            "city": "Opa Locka",
            "state": "FL",
            "postal_code": "330542304",
            "country_code": "US",
            "telephone_number": "305-953-2266",
            "fax_number": "305-953-2251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2504 Acorn St Ste A",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349474746",
            "country_code": "US",
            "telephone_number": "772-837-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSSELMAN",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN9309351",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11027973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "EARNEST",
            "middle_name": "JEAN",
            "credential": "HEALTH SERVICE TECH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.