Individual provider Active NPI

Amanda Pitts Nummy, CRNP, FNP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1770100554
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-150901 Issued in AL
Practice address
330 Saint Lukes Dr
Montgomery, AL 36117-7108
Phone
(334) 270-8864
Fax
(334) 270-1176
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-150901 AL
Family Nurse Practitioner 363LF0000X 1-150901 AL Primary

Addresses

Primary practice location

330 Saint Lukes Dr
Montgomery, AL 36117-7108

Mailing address

330 Saint Lukes Dr
Montgomery, AL 36117-7108
Phone (334) 270-8864

Other identifiers 1

IdentifierTypeStateIssuer
299508MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20201002001917 AL Practitioner - Nurse Practitioner 3678992096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Pediatrics LLC CurrentSince Jan 15, 2023 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 6, 2021 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 6, 2021 Accepting new patients

Locations

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

1401 Highway 14
Millbrook, AL 36054
Phone (334) 310-6059

330 Saint Lukes Dr
Montgomery, AL 36117
Phone (334) 270-8864

Organizations & group practices 3

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1770100554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177108",
            "telephone_number": "334-270-8864",
            "fax_number": "334-270-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177108",
            "telephone_number": "334-270-8864",
            "fax_number": "334-270-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUMMY",
        "first_name": "AMANDA",
        "middle_name": "PITTS",
        "credential": "CRNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-150901",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-150901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299508",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.