Individual provider Active NPI

Amanda L Beerman, NP

  • Nurse Practitioner
  • Marquette, MI
National Provider Identifier
1689754251
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704212505 Issued in MI
Practice address
580 W College Ave
Marquette, MI 49855-2705
Phone
(906) 225-7808
NPI assigned
Oct 17, 2006
Last updated
May 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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 4704212505 MI Primary

Addresses

Primary practice location

580 W College Ave
Marquette, MI 49855-2705

Mailing address

2837 US 41 W
Marquette, MI 49855-2252
Phone (906) 225-3964

Other identifiers 2

IdentifierTypeStateIssuer
5008707190OtherMIBLUE CROSS BLUE SHIELD MI
104684567MedicaidMI

Other names 1

  • Amanda L Labelle Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050124000277 MI Practitioner - Nurse Practitioner 6901856442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-2675

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704212505MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Nov 12, 2012 Accepting new patients
DLP Marquette Physician Practices Inc Nurse Practitioner CurrentSince Nov 12, 2012 Accepting new patients
Northcoast Radiology Associates, PC Past Accepting new patients
DLP Marquette Physician Practices Inc Past Accepting new patients

Locations

1414 W Fair Ave
Ste 249
Marquette, MI 49855
Phone (906) 225-3333

1414 W Fair Ave
Ste 334
Marquette, MI 49855
Phone (906) 225-3870

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

1414 W Fair Ave
Ste 385
Marquette, MI 49855
Phone (906) 225-3808

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1689754251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552705",
            "telephone_number": "906-225-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEERMAN",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704212505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "5008707190",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104684567",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LABELLE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.