Active NPI
Amanda Marie Bishop
- Licensed Practical Nurse
- Ithaca, NY
National Provider Identifier
1730495292
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Mar 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 285441-1
- Practice address
- 138 Cecil Malone Dr
Ithaca, NY 14850-5124 - Phone
- (607) 273-0466
- NPI assigned
- Aug 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 285441-1 | NY | Primary |
Addresses
Primary practice location
138 Cecil Malone Dr
Ithaca, NY 14850-5124
Mailing address
138 Cecil Malone Dr
Ithaca, NY 14850-5124
Phone (607) 273-0466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861606485 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 285441-1 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1730495292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 CECIL MALONE DR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505124",
"telephone_number": "607-273-0466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 CECIL MALONE DR",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505124",
"telephone_number": "607-273-0466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISHOP",
"first_name": "AMANDA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-23",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "285441-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1861606485",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.