Individual provider Active NPI

Amanda Dawn Filosi, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1750781167
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9248442 Issued in FL
Practice address
2624 Atlantic Blvd
Jacksonville, FL 32207-3668
Phone
(904) 513-3240
Fax
(904) 379-2911
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9248442 FL Primary

Addresses

Primary practice location

2624 Atlantic Blvd
Jacksonville, FL 32207-3668

Mailing address

2624 Atlantic Blvd
Jacksonville, FL 32207-3668
Phone (904) 513-3240

Other identifiers 1

IdentifierTypeStateIssuer
016452700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150618000433 FL Practitioner - Nurse Practitioner 5991016941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emed Urgent and Primary Care IncGroup PAC ID 9830381664, 5 clinicians

Practice addresses (Care Compare)

2624 Atlantic Blvd
Suite 1
Jacksonville, FL 32207-3633
Phone (904) 513-3240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9248442FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Health and Nutrition LLC CurrentSince Sep 9, 2020 Accepting new patients

Locations

2624 Atlantic Blvd
Jacksonville, FL 32207
Phone (904) 513-3240

2624 Atlantic Blvd
Ste 6
Jacksonville, FL 32207
Phone (904) 513-3240

2624 Atlantic Blvd
Ste 1
Jacksonville, FL 32207
Phone (904) 413-3360

Interoperability endpoints

  • Direct secure messaging: amanda.filosi@emed.eclinicaldirectplus.com

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1750781167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073668",
            "telephone_number": "904-513-3240",
            "fax_number": "904-379-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073668",
            "telephone_number": "904-513-3240",
            "fax_number": "904-379-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILOSI",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9248442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016452700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.