Amanda K Reichenbach, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

18023 Issued in TN

Practice address

1901 S. Shady Street
Mountain City, TN 37683-2601

Phone

(423) 727-1150

Fax

(423) 727-1134

NPI assigned

Oct 30, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Tennessee State UniversityGroup PAC ID 2769394774, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• East Tennessee State University

  • Federally Qualified Health Center (FQHC)
  • Johnson City, TN
  • NPI 1093990608
  Medicare reassignment Care Compare group NPD
• East Tennessee State University

  • Rural Health Clinic/Center
  • Mountain City, TN
  • NPI 1295779361
  NPD
• East Tennessee State University

  • Federally Qualified Health Center (FQHC)
  • Johnson City, TN
  • NPI 1477660199
  NPD (past)

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1659709673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 STOUT DRIVE BOX 70403",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141703",
            "telephone_number": "423-439-4515",
            "fax_number": "423-439-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S. SHADY STREET",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832601",
            "telephone_number": "423-727-1150",
            "fax_number": "423-727-1134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2151 Century Ln",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376044469",
            "country_code": "US",
            "telephone_number": "423-926-2500",
            "fax_number": "423-926-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHENBACH",
        "first_name": "AMANDA",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533577",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy M Proffitt, RPH
• Adam Michael Qualls, DMD
• Randal J Rabon II, O.D.
• Joe A Ray, DDS
• Harry S. Reece, DPH
• Elizabeth Ann Rhymer
• Jordan Robertson, PHARMD
• Bethany Monique Rock, FNP
• Rural Health Services Consortium of Upper East Tennessee Inc
• SHC Medical Partners of Tennessee, LLC

• Family Nurse Practitioner in Mountain City, TN
• Providers in Mountain City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.