Amy Anderson, AGACNP-BC

Individual provider Active NPI Acute Care Nurse Practitioner · Port Arthur, TX

NPI 1649915331 · NPPES record last updated Mar 13, 2023

Key facts

NPI
1649915331
Entity type
Individual (NPI type 1)
Primary specialty
Acute Care Nurse Practitioner 363LA2100X
License
1076007 (TX)
Practice address
2501 Jimmy Johnson Blvd
Suite 401
Port Arthur, TX 77640
Phone
(409) 401-5864
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 8

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winnie Community Hospital LLC (23 clinicians)

Practice addresses (Care Compare)

538 Broadway
Winnie, TX 77665-7600
Phone (409) 296-6000

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220602001191 TX Practitioner - Nurse Practitioner 5496133548 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winnie Community Hospital LLC Current Accepting new patients
Winnie Community Hospital, L.L.C. Current
since Feb 13, 2023
Accepting new patients

Locations

2501 Jimmy Johnson Blvd
Ste 401
Port Arthur, TX 77640
Phone (409) 401-5864

538 Broadway
Winnie, TX 77665
Phone (409) 296-6000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1076007 TX Yes

Addresses

Primary practice location

2501 Jimmy Johnson Blvd
Suite 401
Port Arthur, TX 77640

Mailing address

2501 Jimmy Johnsonblvd
Suite 401
Port Arthur, TX 77640

Other practice location 1

8595 Medical Center Blvd
Port Arthur, TX 77640
Phone (409) 721-8600

Other practice location 2

538 Broadway
Winnie, TX 77665-7600
Phone (409) 296-6505

Other practice location 3

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

Other providers in Port Arthur, TX

All providers in Port Arthur, TX · Acute Care Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.