Amanda Shay Tice, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

703553 Issued in TX

Practice address

1000 Houston Street
Suite 200
Fort Worth, TX 76102

Phone

(817) 336-0551

Fax

(817) 339-3940

NPI assigned

Jun 14, 2013

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

Other names 1

• Amanda Shay Medlin Former name

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acclaim Physician Group IncGroup PAC ID 4587963582, 520 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• JPS Health Network Hospital, Fort Worth, TX, CCN 450039

Merit-based Incentive Payment System (MIPS)

Final score

96.38 of 100Reported as group

Quality

80.41

Promoting interoperability

100

Improvement activities

40

Cost

78.69

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tarrant County Hospital District

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1992753222
  Care Compare affiliation

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1740629591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUSTON STREET",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-336-0551",
            "fax_number": "817-339-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOUSTON STREET",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-336-0551",
            "fax_number": "817-339-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "AMANDA",
        "middle_name": "SHAY",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "703553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MEDLIN",
            "middle_name": "SHAY",
            "credential": "ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madison Belle Thurman
• Scott A Thurman, MD
• Tracy Thurmond
• Miekka Estelle Thye, M.S., CCC/SLP
• Daniel Tiblets
• Christi Tice, LCDC
• Tristin Tice
• Rachael Ticer, MS
• Heath William Hall Tidwell
• Olivia Tidwell

• Acute Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.