Individual provider Active NPI

Amanda Nicole O'Rourke, FNP

  • Family Nurse Practitioner
  • Walled Lake, MI
National Provider Identifier
1750963203
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704283328 Issued in MI
Practice address
100 W West Maple Rd
Walled Lake, MI 48390-3402
Phone
(248) 624-4555
NPI assigned
Apr 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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 4704283328 MI Primary

Addresses

Primary practice location

100 W West Maple Rd
Walled Lake, MI 48390-3402

Mailing address

14406 Melvin St
Livonia, MI 48154-4452
Phone (313) 318-2281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210623002645 MI Practitioner - Nurse Practitioner 7214338672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio Medical University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Michigan PCGroup PAC ID 9133123755, 40 clinicians

Practice addresses (Care Compare)

39350 9 Mile Rd
Northville, MI 48167-9164
Phone (866) 389-2727

Merit-based Incentive Payment System (MIPS)

Final score
81.3 of 100Reported as group
Quality
76.96
Improvement activities
40
Cost
79.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704283328MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care-Michigan PLLC Family CurrentSince Sep 12, 2025 Accepting new patients
Minuteclinic Diagnostic of Michigan PC Family CurrentSince Apr 30, 2021 Accepting new patients

Locations

44300 5 Mile Rd
Northville, MI 48168
Phone (734) 416-1883

39350 9 Mile Rd
Northville Township, MI 48167
Phone (248) 735-6081

30920 Southfield Rd
Southfield, MI 48076
Phone (248) 515-7513

100 W West Maple Rd
Walled Lake, MI 48390
Phone (248) 624-4555

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1750963203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14406 MELVIN ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544452",
            "telephone_number": "313-318-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W WEST MAPLE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903402",
            "telephone_number": "248-624-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-24",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704283328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

Verify at the official NPI Registry.