Amanda Smith Martinez, NP

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

License

AP10182 Issued in LA

Practice address

216 Evangeline St
Deridder, LA 70634-4251

Phone

(337) 463-4486

NPI assigned

Apr 10, 2019

Sex

Female

Sole proprietor

No

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 LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.brocato@ldhoph.directbygreenway.com

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.

• Louisiana Department of Health - Office of Public Health

  dba Child Spec Health Services

  • Public Health or Welfare Agency
  • New Orleans, LA
  • NPI 1144372343
  Medicare reassignment NPD
• Louisiana Department of Health - Office of Public Health

  dba Office of Public Health

  • Public Health or Welfare Agency
  • Baton Rouge, LA
  • NPI 1396316212
  NPD

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1710440466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 EVANGELINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344251",
            "telephone_number": "337-463-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 EVANGELINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344251",
            "telephone_number": "337-463-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AMANDA",
        "middle_name": "SMITH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "LA",
            "license": "AP10182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Renee Mahaffey, APRN
• Julie Strother Mahaffey, WHNP
• Caroline Mann
• Yolanda Marbury
• Samantha Martin
• Stanley C Maskas, DDS
• Kimberly Mayes
• Jennifer R McCann
• Ashley Marie McCartney
• Clarke McLaughlin, LMFT, LPC, LAC, CEAP

• Community Health Nurse Practitioner in Deridder, LA
• Providers in Deridder, LA by specialty
• Community Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.