Individual provider Active NPI

Amanda Nicole Kilgallon, PMHNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • South Kingstown, RI
National Provider Identifier
1750264354
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN05002 Issued in RI
Practice address
65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone
(401) 785-0040
NPI assigned
Jul 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 15148 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN05002 RI Primary

Addresses

Primary practice location

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569

Mailing address

108 New London Tpke Ste 1
Norwich, CT 06360-2645

Other practice location 1

108 New London Tpke Ste 1
Norwich, CT 06360-2645
Phone (860) 889-3052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20260304004110 RI Practitioner - Nurse Practitioner 0244712651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

65 Village Square Dr
Suite 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15148CTMDPsychiatric/Mental Health Nurse Practitioner
APRN05002RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. CurrentSince Mar 9, 2026 Accepting new patients
Norwich Psychiatric Center Psychiatric/Mental Health PastSince Aug 3, 2025 Accepting new patients

Locations

65 Village Square Dr
Ste 302
South Kingstown, RI 02879
Phone (844) 754-6564

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1750264354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 NEW LONDON TPKE STE 1",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VILLAGE SQUARE DR STE 302",
            "city": "SOUTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028792569",
            "telephone_number": "401-785-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 New London Tpke Ste 1",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602645",
            "country_code": "US",
            "telephone_number": "860-889-3052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILGALLON",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "PMHNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-30",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "15148",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN05002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Kingstown, RI

Sources for this page

Verify at the official NPI Registry.