Active NPI
Amanda Michelle Northern, NP-C
- Nurse Practitioner
- Portsmouth, VA
National Provider Identifier
1780081018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 0024172143
- Practice address
- 3600 High St
Portsmouth, VA 23707-3236 - Phone
- (757) 215-3100
- Fax
- (757) 398-9263
- NPI assigned
- Dec 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 0024172143 | VA | Primary |
Addresses
Primary practice location
3600 High St
Portsmouth, VA 23707-3236
Mailing address
3600 High St
Portsmouth, VA 23707-3236
Phone (757) 215-3100
Other names 1
- Amanda Fales Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3537 Airline Blvd
Suite 1
Portsmouth, VA 23701-2650
Phone (757) 738-1225
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024172143 | VA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Hampton Roads Primary Care LLC | Current | Accepting new patients |
Locations
155 Kingsley Ln
Ste 150
Norfolk, VA 23505
Phone (757) 278-2350
3600 High St
Portsmouth, VA 23707
Phone (757) 215-3100
3537 Airline Blvd
Ste 1
Portsmouth, VA 23701
Phone (757) 738-1225
8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462
Interoperability endpoints
- anorthern1154249@direct.bsmhealth.org
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Richmond, VA
- NPI 1528627379
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Suffolk, VA
- NPI 1104658434
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
-
- General Acute Care Hospital
- Suffolk, VA
- NPI 1376540138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1780081018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 HIGH ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237073236",
"telephone_number": "757-215-3100",
"fax_number": "757-398-9263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 HIGH ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237073236",
"telephone_number": "757-215-3100",
"fax_number": "757-398-9263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHERN",
"first_name": "AMANDA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-02",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024172143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "SMITH",
"middle_name": "FALES",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.