Amanda Tully, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN106874 Issued in WV

Practice address

1824 Murdoch Ave BLDG C
Parkersburg, WV 26101-3230

Phone

(304) 916-1881

NPI assigned

Aug 3, 2020

Last updated

Aug 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Joseph Recovery Center, LLCGroup PAC ID 0042548000, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St. Joseph Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Parkersburg, WV
  • NPI 1174021406

  OH

  Medicare reassignment Care Compare group NPD
• Grace Medical Group, LLC

  • Family Nurse Practitioner
  • Parkersburg, WV
  • NPI 1376172494
  Medicare reassignment NPD

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1790395069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 MURDOCH AVE BLDG C",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013230",
            "telephone_number": "304-916-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MURDOCH AVE BLDG C",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261013230",
            "telephone_number": "304-916-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "AMANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN106874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Tucker
• Kayla Tucker
• Tisharrah Tucker, PRSS
• Trista Tucker
• Tristan Tucker
• Eva Tupper
• Stella Dawn Turner, BA
• Christina Marie Turrill, PTA
• Tracy M Tynan, CARE COORDINATOR
• Rhonda Tyree, LMT

• Family Nurse Practitioner in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.

Verify at the official NPI Registry.