Amanda Nache Spates

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F09250414 Issued in SC

Practice address

4076 N Williamsburg Hwy
Lake City, SC 29560

Phone

(843) 373-2504

NPI assigned

Mar 23, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1669310629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 N WILLIAMSBURG HWY",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "29560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 N WILLIAMSBURG HWY",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "29560",
            "telephone_number": "843-373-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATES",
        "first_name": "AMANDA",
        "middle_name": "NACHE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "F09250414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlie Dorn Smith III, MD
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• South Carolina CVS Pharmacy LLC
• Dominique Sophia Destiny Speaks, FNP
• Courtney Gibbs Stanley, PA
• Steele Hearing
• Leslie Erin Blackmon Stelling, PHARM D
• Robyn Dyson Stephenson

• Nurse Practitioner in Lake City, SC
• Providers in Lake City, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.