Amanda Jean Richardson, RN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11728 Issued in MN

Practice address

9655 Schmidt Lake Rd
Plymouth, MN 55442-4529

Phone

(763) 559-1640

NPI assigned

Jun 27, 2022

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Plymouth Psych Group LLCGroup PAC ID 6800103490, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Plymouth Psych Group, LLC

  • Mental Health Counselor
  • Plymouth, MN
  • NPI 1003195942
  Medicare reassignment Care Compare group NPD
• Volunteers of America MN

  dba Children's REsidential Treatment Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Minnetonka, MN
  • NPI 1275592081
  NPD (past)

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1669104899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 UPTON AVE S",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372171",
            "telephone_number": "763-913-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 SCHMIDT LAKE RD",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554424529",
            "telephone_number": "763-559-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "RN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MN",
            "license": "179569-9",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "11728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey May Reynolds, CRNA
• Christopher John Reynolds, DO
• Richard Larson Chiropractic, LLC
• Melody Joy Richards, MA, LPC
• Nathan Robert Richards
• Lawrence Gale Richmond, MD
• Michael Joseph Richter
• Sara Ridley
• Tyler Lawrence Rieck
• Rachel Riley, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.