Amanda Cheatham, APRN
Individual provider Active NPI Nurse Practitioner · Canehill, AR
NPI 1659997351 · NPPES record last updated Jun 18, 2020
Key facts
- NPI
- 1659997351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 124084 (AR)
- Practice address
- 16832 Prince Rd
Canehill, AR 72717-9415 - Phone
- (479) 220-1513
- NPI assigned
- Jun 18, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Appello Health and Wellness Clinic LLC
Washington Regional Medical System
Practice addresses (Care Compare)
2223 Grant St
Malvern, AR 72104-4700
Phone (501) 337-9031
3215 N Northhills Blvd
Washington Regional Hospital Medicine Group
Fayetteville, AR 72703-4424
Phone (479) 463-7102
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201125000554 | AR | Practitioner - Nurse Practitioner | 7719398692 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Fort Smith Communities | Current |
Accepting new patients | |
| Appello Health and Wellness Clinic, LLC | Current |
Accepting new patients | |
| Washington Regional Medical System | Current |
Accepting new patients | |
| Washington Regional Medical System | Current |
Accepting new patients | |
| Washington Regional Medical System | Current | Accepting new patients | |
| Mercy Clinic Fort Smith Communities | Current |
Accepting new patients | |
| Washington Regional Medical System | Past | Accepting new patients |
Locations
3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000
114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597
7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600
7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620
2223 Grant St
Malvern, AR 72104
Phone (501) 337-9031
Interoperability endpoints
- acheatham26520@washingtonregional.direct-ci.com
- amanda.cheatham@aphw.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 124084 | AR | Yes |
Addresses
Primary practice location
16832 Prince Rd
Canehill, AR 72717-9415
Mailing address
16832 Prince Rd
Canehill, AR 72717-9415
Phone (479) 220-1513
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.