Amanda Bour, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704372464 Issued in MI

Practice address

30695 Little Mack Ave Ste 500
Roseville, MI 48066-1772

Phone

(313) 401-0256

NPI assigned

Sep 10, 2019

Reactivated

Oct 17, 2025

Last updated

Jul 23, 2026By the provider in NPPES

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

Enrolled in MI

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

University of Cincinnati College of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aii Medicine PLLCGroup PAC ID 7618477324, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aii Medicine PLLC

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1043048077
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1689223877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30695 LITTLE MACK AVE STE 500",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480661772",
            "telephone_number": "313-401-0256",
            "fax_number": "888-212-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30695 LITTLE MACK AVE STE 500",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480661772",
            "telephone_number": "313-401-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUR",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "deactivation_date": "2025-10-01",
        "reactivation_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704372464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Water Counseling and Wellness Center, Inc.
• Paul S Blunden, M.D.
• Giovanni Bollini
• Heidi Boothby
• Bormans Inc (Farmer Jack Pharmacy)
• Earl Benjamin Boyd III
• Hillary Brass, CNM
• Rebecca L Bremer, DO
• Kelsey Anne Brengman, PA-C
• Robert Brinker, OD

• Primary Care Nurse Practitioner in Roseville, MI
• Providers in Roseville, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.