Individual provider Active NPI

Amanda Chandler Hill

  • Nurse Practitioner
  • Cleveland, MS
National Provider Identifier
1669990040
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
HILL-01B81J Issued in MS
Practice address
810 E Sunflower Rd Ste 100B
Cleveland, MS 38732-2828
Phone
(662) 579-3484
Fax
(662) 579-3485
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X HILL-01B81J MS Primary

Addresses

Primary practice location

810 E Sunflower Rd Ste 100B
Cleveland, MS 38732-2828

Mailing address

810 E Sunflower Rd Ste 100B
Cleveland, MS 38732-2828
Phone (662) 579-3484

Other identifiers 1

IdentifierTypeStateIssuer
HILL-01B81JOtherMSMISSISSIPPI BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20171102003295 MS Practitioner - Nurse Practitioner 3476819756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Access Center of Bolivar County LLCGroup PAC ID 9931239365, 3 clinicians

Practice addresses (Care Compare)

810 E Sunflower Rd
Suite 100B
Cleveland, MS 38732-2828
Phone (662) 579-3484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
HILL-01B81JMSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Access Center of Bolivar County LLC CurrentSince Oct 1, 2017 Accepting new patients
Radiology Services P a PastSince Oct 1, 2017 Accepting new patients

Locations

810 E Sunflower Rd
Ste 100B
Cleveland, MS 38732
Phone (662) 579-3484

285 Wilmington W Chester Pike
Chadds Ford, PA 19317
Phone (302) 438-8900

Interoperability endpoints

  • Direct secure messaging: amanda.hill.bol@direct.vac.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1669990040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E SUNFLOWER RD STE 100B",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322828",
            "telephone_number": "662-579-3484",
            "fax_number": "662-579-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E SUNFLOWER RD STE 100B",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322828",
            "telephone_number": "662-579-3484",
            "fax_number": "662-579-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "AMANDA",
        "middle_name": "CHANDLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2024-06-18",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "HILL-01B81J",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI BOARD OF NURSING",
            "identifier": "HILL-01B81J",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

Verify at the official NPI Registry.