Individual provider Active NPI

Amanda Stilley Bickham, FNP-C

  • Family Nurse Practitioner
  • Carthage, TX
National Provider Identifier
1720654445
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1020501 Issued in TX
Practice address
409 Cottage Rd
Carthage, TX 75633-1466
Phone
(903) 694-3841
NPI assigned
Jun 2, 2021
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1020501 TX
Family Nurse Practitioner 363LF0000X 1020501 TX Primary

Addresses

Primary practice location

409 Cottage Rd
Carthage, TX 75633-1466

Mailing address

409 Cottage Rd
Carthage, TX 75633-1466
Phone (903) 694-3841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230109002014 TX Practitioner - Nurse Practitioner 7214307206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

2000 S Palestine St
Athens, TX 75751-5610
Phone (903) 676-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1020501TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Point - Desoto LLC Family CurrentSince Sep 29, 2022 Accepting new patients
Pallicare, Inc CurrentSince Feb 19, 2026 Accepting new patients
Acs Primary Care Physicians Southwest, PA Nurse Practitioner CurrentSince Jan 1, 2024 Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Camino Real Emergency Physicians PLLC Nurse Practitioner Past Accepting new patients

Locations

2000 S Palestine St
Athens, TX 75751
Phone (903) 675-2216

409 Cottage Rd
Carthage, TX 75633
Phone (903) 693-3841

2312 W 7th Ave
Corsicana, TX 75110
Phone (903) 448-7611

1601 Elm St
Ste 4210
Dallas, TX 75201

1111 N Interstate 35 E
Desoto, TX 75115
Phone (469) 530-9220

300 Wilson St
Henderson, TX 75652
Phone (903) 655-6536

1517 E Rusk St
Jacksonville, TX 75766
Phone (903) 339-2370

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

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.

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1720654445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-694-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-694-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLEY BICKHAM",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1020501",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1020501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, TX

Sources for this page

Verify at the official NPI Registry.