Individual provider Active NPI

Amanda Gayle Huffstetler, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1780076521
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5007500 Issued in NC
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4944
NPI assigned
Mar 3, 2015
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5007500 NC Primary
Neonatal Nurse Practitioner 363LN0000X 5007500 NC
Neonatal Nurse Practitioner 363LN0000X 102323 NC

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4944

Other practice location 1

20 Medical Campus Dr NW Ste 205
Supply, NC 28462-4094
Phone (910) 721-4400

Other names 1

  • Amanda H Spargo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230227000502 NC Practitioner - Nurse Practitioner 6406229210 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102323NCMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 20, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 20, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

20 Medical Campus Dr NW
Ste 205
Supply, NC 28462
Phone (910) 721-4400

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: ateague44068@direct.novanthealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1780076521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Medical Campus Dr NW Ste 205",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284624094",
            "country_code": "US",
            "telephone_number": "910-721-4400",
            "fax_number": "910-721-4409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUFFSTETLER",
        "first_name": "AMANDA",
        "middle_name": "GAYLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007500",
            "primary": true
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NC",
            "license": "5007500",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NC",
            "license": "102323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SPARGO",
            "middle_name": "H",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.