Amanda Ashley Thomas, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

27163 Issued in TN

Practice address

2500 Jacksboro Pike Ste 6
Jacksboro, TN 37757-2818

Phone

(423) 352-6500

NPI assigned

Feb 15, 2020

Last updated

Feb 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Kentucky, PLLCGroup PAC ID 0143525998, 213 clinicians

Eastlake Medical, PLLCGroup PAC ID 6901174788, 6 clinicians

Brock Medical, LLCGroup PAC ID 9830354638, 93 clinicians

Practice addresses (Care Compare)

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.

• Eastlake Medical, PLLC

  dba Eastlake Urgent Care

  • Rural Health Clinic/Center
  • La Follette, TN
  • NPI 1467992446
  Medicare reassignment Care Compare group NPD
• Brock Medical, LLC

  dba First Care Clinics, LLC

  • Nurse Practitioner
  • London, KY
  • NPI 1023379815
  Medicare reassignment Care Compare group NPD
• Fast Pace Kentucky PLLC

  dba Fast Pace Urgent Care

  • Family Nurse Practitioner
  • Franklin, KY
  • NPI 1457716706
  Medicare reassignment Care Compare group NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  KY

  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  dba Fast Pace Health

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1669256913
  NPD
• Fast Pace Kentucky, PLLC

  dba Fast Pace Health

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Bardstown, KY
  • NPI 1184381444
  NPD (past)

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1700419090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 DORCHESTER AVE",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652227",
            "telephone_number": "606-670-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 JACKSBORO PIKE STE 6",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377572818",
            "telephone_number": "423-352-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Middlesboro",
            "state": "KY",
            "postal_code": "409651029",
            "country_code": "US",
            "telephone_number": "606-619-3060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1402 Dorchester Ave",
            "address_purpose": "LOCATION",
            "city": "Middlesboro",
            "state": "KY",
            "postal_code": "409652227",
            "country_code": "US",
            "telephone_number": "606-670-4474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "AMANDA",
        "middle_name": "ASHLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "1158104",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Jane Teague
• Casey Terry
• Terry's Pharmacy, Inc.
• Terrys Pharmacy Inc (Terrys Pharmacy Jacksboro)
• Chelsea M Thacker, PA-C
• Norma B Tidwell, NA
• Timothy M Hall DMD PC
• Valley Medical
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1466)
• Wal-Mart Stores East, LP (Vision Center 30-1466)

• Family Nurse Practitioner in Jacksboro, TN
• Providers in Jacksboro, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.