Individual provider Active NPI

Amanda Partin, RN

  • Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1750890349
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP09744 Issued in LA
Practice address
600 Dr Michael Debakey Dr
Lake Charles, LA 70601-5727
Phone
(337) 436-3813
Fax
(337) 493-4355
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN133944 LA
Nurse Practitioner 363L00000X AP09744 LA Primary

Addresses

Primary practice location

600 Dr Michael Debakey Dr
Lake Charles, LA 70601-5727

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 312-8528

Other practice location 1

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 312-8528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20180219001191 LA Practitioner - Nurse Practitioner 5395006118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imperial Health LLPGroup PAC ID 7719886779, 75 clinicians

Practice addresses (Care Compare)

501 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 433-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN133944LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Health LLP CurrentSince Feb 1, 2018 Accepting new patients
Imperial Health, LLP CurrentSince Feb 1, 2018 Accepting new patients

Locations

501 Shirley St
Deridder, LA 70634
Phone (337) 202-7850

607 N Thomson Ave
Iowa, LA 70647
Phone (337) 582-5555

600 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 439-5800

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

Interoperability endpoints

  • Direct secure messaging: amanda.partin@1288.direct.myezyaccess.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.

Hospital & facility affiliations 5

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750890349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-312-8528",
            "fax_number": "337-312-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015727",
            "telephone_number": "337-436-3813",
            "fax_number": "337-493-4355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Dr Michael Debakey Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706015724",
            "country_code": "US",
            "telephone_number": "337-312-8528",
            "fax_number": "337-312-6708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARTIN",
        "first_name": "AMANDA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN133944",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP09744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.