Individual provider Active NPI

Amanda Sue Morris, FNP

  • Family Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1790540425
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024188464 Issued in VA
Practice address
47 Charter Gate Dr
Fredericksburg, VA 22406-8206
Phone
(910) 554-9514
NPI assigned
Feb 21, 2024
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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 0024188464 VA Primary

Addresses

Primary practice location

47 Charter Gate Dr
Fredericksburg, VA 22406-8206

Mailing address

47 Charter Gate Dr
Fredericksburg, VA 22406-8206
Phone (910) 554-9514

Other names 1

  • Amanda Sue Jibson Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509004115 VA Practitioner - Nurse Practitioner 5799126553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
MWHC Urgent Care LLCGroup PAC ID 8921338427, 20 clinicians

Practice addresses (Care Compare)

955 Wonder Rd
Suite C
Stafford, VA 22554-7798
Phone (540) 741-7890

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MWHC Urgent Care LLC Current Accepting new patients
MWHC Urgent Care LLC CurrentSince Apr 21, 2024 Accepting new patients
MWHC Urgent Care LLC Past Accepting new patients

Locations

10 Stafford Lakes Pkwy
Ste 102
Fredericksburg, VA 22406
Phone (540) 737-6144

1340 Central Park Blvd
Ste 100
Fredericksburg, VA 22401

4900 Plank Rd
#101
Fredericksburg, VA 22407
Phone (540) 741-0679

11131 Journal Pkwy
Ste A
King George, VA 22485
Phone (540) 709-5173

955 Wonder Rd
Ste C
Stafford, VA 22554
Phone (540) 741-7890

Interoperability endpoints

  • Direct secure messaging: ajibson57656@marywashingtonhealthcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1790540425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CHARTER GATE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224068206",
            "telephone_number": "910-554-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CHARTER GATE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224068206",
            "telephone_number": "910-554-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "JIBSON",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.