NPIMap

Individual provider Active NPI

Amanda Lee Baker, FNP-BC

  • Family Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1750957338
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5014509 Issued in NC
Practice address
1074 Southern Ave
Fayetteville, NC 28306-1766
Phone
(910) 491-4530
NPI assigned
Jun 3, 2021
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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 5014509 NC Primary

Addresses

Primary practice location

1074 Southern Ave
Fayetteville, NC 28306-1766

Mailing address

4225 Bent Grass Dr
Fayetteville, NC 28312-8719
Phone (910) 491-9418

Other practice location 1

3551 Dunn Rd Ste 101
Eastover, NC 28312-9417
Phone (910) 483-6277

Other practice location 2

1515 Sunset Ave
Clinton, NC 28328-3827
Phone (910) 491-9418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210918000014 NC Practitioner - Nurse Practitioner 9032516083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Simpleclinic PLLCGroup PAC ID 2264730621, 7 clinicians

Practice addresses (Care Compare)

1515 Sunset Ave
Clinton, NC 28328-3827
Phone (910) 491-9418

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5014509NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Simpleclinic PLLC CurrentSince Oct 21, 2021 Accepting new patients
Simpleclinic PLLC Past Accepting new patients

Locations

1515 Sunset Ave
Clinton, NC 28328
Phone (910) 491-9418

3551 Dunn Rd
Ste 101
Eastover, NC 28312
Phone (910) 483-6277

1074 Southern Ave
Fayetteville, NC 28306
Phone (910) 221-1590

Interoperability endpoints

  • Direct secure messaging: abaker119119@capefearvalley.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1750957338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 BENT GRASS DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283128719",
            "telephone_number": "910-491-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 SOUTHERN AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283061766",
            "telephone_number": "910-491-4530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Dunn Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Eastover",
            "state": "NC",
            "postal_code": "283129417",
            "country_code": "US",
            "telephone_number": "910-483-6277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Sunset Ave",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "NC",
            "postal_code": "283283827",
            "country_code": "US",
            "telephone_number": "910-491-9418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.