Amanda L Gillenwater, APRN-CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN.CNP.0027743 Issued in OH

Practice address

2159 Dogwood Ridge Rd
Wheelersburg, OH 45694-9044

Phone

(731) 394-1145

NPI assigned

Jan 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, KY, IN3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Eventus Wholehealth Midwest IncGroup PAC ID 4183040470, 120 clinicians

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson Memorial Hospital Hospital, Franklin, IN, CCN 150001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  KY, OH

  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth Midwest Inc

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1386252757

  KY, OH

  Medicare reassignment Care Compare group NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  KY, OH

  Medicare reassignment Care Compare group NPD
• Eventus Ecs - Kentucky, PLLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1396563276

  IN

  Medicare reassignment NPD
• Eventus WH Midwest Care, LLC

  • Nurse Practitioner
  • Concord, NC
  • NPI 1588481717

  IN, KY

  Medicare reassignment NPD

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

• Johnson Memorial Hospital

  • General Acute Care Hospital
  • Franklin, IN
  • NPI 1346248986
  Care Compare affiliation
• Johnson Memorial Hospital

  • Occupational Medicine Clinic/Center
  • Franklin, IN
  • NPI 1679577357

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1649744384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PEMBERTON CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055514",
            "telephone_number": "731-394-1145",
            "fax_number": "844-374-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2159 DOGWOOD RIDGE RD",
            "city": "WHEELERSBURG",
            "state": "OH",
            "postal_code": "456949044",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Ironton",
            "state": "OH",
            "postal_code": "456381502",
            "country_code": "US",
            "telephone_number": "740-532-1613",
            "fax_number": "740-532-1715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLENWATER",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.454549",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0027743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0331807",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Frazier, LISW-S, LCSW
• Britnie Leigh Gay
• Melton M Gay
• Kyle M. Gibson, PA-C
• Brennon E Giles, NURSE PRACTIONER
• Tina Ranae Gills
• Terry Gillum
• Rasha Effie Irene Ginn, LPN
• Micah Erin Glenn, MSN, APRN, FNP-C
• Melva Jeanne Gordon, NURSE PRACTITIONER

• Gerontology Nurse Practitioner in Wheelersburg, OH
• Providers in Wheelersburg, OH by specialty
• Gerontology Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.