Active NPI
Amanda Lee Trevino, FNP
- Family Nurse Practitioner
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2018044128
- Practice address
- 1540 E Evergreen St
Springfield, MO 65803-4300 - Phone
- (417) 823-2900
- Fax
- (417) 886-2774
- NPI assigned
- Jan 2, 2019
- Last updated
- Aug 21, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2018044128 | MO | Primary |
Addresses
Primary practice location
1540 E Evergreen St
Springfield, MO 65803-4300
Mailing address
3183 E Liberty St
Republic, MO 65738-7826
Phone (417) 755-6486
Other practice location 1
101 S Main St
Rogersville, MO 65742-9357
Phone (417) 753-9404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1540 E Evergreen St
Springfield, MO 65803-4300
Phone (417) 823-2900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22831 | SC | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sgoh Acquisition Inc | Current | Accepting new patients | |
| Primrose Nephrology, Inc. | Current | Accepting new patients | |
| Elite Pain Management, LLC | Current | Accepting new patients | |
| Sgoh Acquisition Inc | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221
106 S Hickory St
Mount Vernon, MO 65712
Phone (417) 466-4110
101 S Main St
Rogersville, MO 65742
Phone (417) 753-9404
1540 E Evergreen St
Springfield, MO 65803
Phone (417) 823-2900
222 E Primrose St
Ste E
Springfield, MO 65807
Phone (417) 553-1080
4237 River Hills Dr
Ste 170
Little River, SC 29566
Phone (843) 273-0376
8212 Devon Ct
Myrtle Beach, SC 29572
Phone (843) 273-0379
Interoperability endpoints
- elitepainmanagement.amandatrevino@133100.advancedmd-direct.com
Organizations & group practices 5
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.
-
- Clinic/Center
- Springfield, MO
- NPI 1114924768
-
- Specialist
- Springfield, MO
- NPI 1225163116
-
- Pain Medicine Physician
- Little River, SC
- NPI 1457727752
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Cox Medical Centers
- General Acute Care Hospital
- Springfield, MO
- NPI 1093740128
-
dba Cox Air Care
- Air Ambulance
- Springfield, MO
- NPI 1578680286
Hospital
-
dba Ozarks Community Hospital of Gravette
- Critical Access Hospital
- Gravette, AR
- NPI 1568643005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1710450762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3183 E LIBERTY ST",
"city": "REPUBLIC",
"state": "MO",
"postal_code": "657387826",
"telephone_number": "417-755-6486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 E EVERGREEN ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658034300",
"telephone_number": "417-823-2900",
"fax_number": "417-886-2774"
}
],
"practiceLocations": [
{
"address_1": "101 S Main St",
"address_purpose": "LOCATION",
"city": "Rogersville",
"state": "MO",
"postal_code": "657429357",
"country_code": "US",
"telephone_number": "417-753-9404",
"fax_number": "417-753-9137",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TREVINO",
"first_name": "AMANDA",
"middle_name": "LEE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-02",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2018044128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.