Individual provider Active NPI

Amanda M Bramham, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1689994014
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-133693 Issued in IL
Practice address
1029 E 130TH St
Chicago, IL 60628-6908
Phone
(773) 995-6300
NPI assigned
Jun 8, 2010
Last updated
May 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 101592 WI
Family Medicine Physician 207Q00000X 83732-20 WI
Family Medicine Physician 207Q00000X 036-133693 IL Primary

Addresses

Primary practice location

1029 E 130TH St
Chicago, IL 60628-6908

Mailing address

1005 Health Center Dr Ste 201
Mattoon, IL 61938-4693
Phone (217) 238-6055

Other practice location 1

833 S Iowa St Ste 102
Dodgeville, WI 53533-1900
Phone (608) 935-3301

Other practice location 2

200 Richmond Ave E
Mattoon, IL 61938-4652
Phone (217) 234-7000

Other identifiers 2

IdentifierTypeStateIssuer
1689994014MedicaidWI
1689994014MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abramham506115@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131004000235 IL Practitioner - Family Practice 5991939050 Reassigns benefits to 2 organizations
I20240416002944 WI Practitioner - Family Practice 5991939050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tca Health Inc NFPGroup PAC ID 5991696643, 18 clinicians
Crawford Hospital DistrictGroup PAC ID 7719898071, 71 clinicians

Practice addresses (Care Compare)

1029 E 130TH St
Chicago, IL 60628-6908
Phone 7739956300254

1101 N Allen St
Robinson, IL 62454-1168
Phone (618) 544-3699

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-133693ILMDFamily Medicine Physician
101592WIMDFamily Medicine Physician
83732-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Tca Health Inc NFP CurrentSince May 19, 2025 Accepting new patients
Tca Health Inc NFP CurrentSince May 19, 2025 Accepting new patients
Crawford Hospital District CurrentSince Jan 26, 2026 Accepting new patients
Dean Health Systems, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Crawford Hospital District Family Medicine CurrentSince Jan 26, 2026 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Crawford Hospital District Past Accepting new patients

Locations

1029 E 130th St
Chicago, IL 60628
Phone (773) 995-6300

8425 S Cottage Grove Ave
Chicago, IL 60619
Phone (708) 225-0643

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

1002 N Allen St
Ste B
Robinson, IL 62454

1101 N Allen St
Robinson, IL 62454
Phone (618) 544-3125

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: abramham506115@direct-ehr-ssmhc.com
  • Direct secure messaging: amanda.bramham.1@15548.direct.athenahealth.com

Organizations & group practices 8

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 2

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1689994014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384693",
            "telephone_number": "217-238-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 E 130TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606286908",
            "telephone_number": "773-995-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 S Iowa St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Dodgeville",
            "state": "WI",
            "postal_code": "535331900",
            "country_code": "US",
            "telephone_number": "608-935-3301",
            "fax_number": "608-935-3823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Richmond Ave E",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384652",
            "country_code": "US",
            "telephone_number": "217-234-7000",
            "fax_number": "217-234-7011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAMHAM",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "101592",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "83732-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-133693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689994014",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689994014",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abramham506115@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "abramham506115@direct-ehr-ssmhc.com",
            "address_1": "833 S Iowa St Ste 102",
            "city": "Dodgeville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535331900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "833 S Iowa St Ste 102",
            "city": "Dodgeville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535331900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.