Amanda Jean Pinnock, NP-C
Individual provider Active NPI Family Nurse Practitioner · Hallock, MN
NPI 1811303944 · NPPES record last updated Jul 9, 2014
Key facts
- NPI
- 1811303944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R-205070-2 (MN)
- Practice address
- 1010 S Birch Ave
Hallock, MN 56728-4215 - Phone
- (218) 843-2165
- Fax
- (218) 843-2311
- NPI assigned
- Jul 9, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of North Dakota School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kittson Memorial Hospital Association
Practice addresses (Care Compare)
1 St and Roosevelt
Karlstad, MN 56732
Phone (218) 436-2251
1010 S Birch Ave
Hallock, MN 56728-4215
Phone (218) 843-3612
Hospital & facility affiliations
- Kittson Healthcare
- Sanford Thief River Falls Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140804001694 | MN | Practitioner - Nurse Practitioner | 6305063033 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1023 | MN | MD | Acupuncturist |
| R-205070-2 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kittson Memorial Hospital Association | Current |
Accepting new patients | |
| Kittson Memorial Hospital Association | Current |
Accepting new patients |
Locations
1010 S Birch Ave
Hallock, MN 56728
Phone (218) 843-3612
205 Roosevelt Ave W
Karlstad, MN 56732
Phone (218) 436-2251
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R-205070-2 | MN | Yes |
Addresses
Primary practice location
1010 S Birch Ave
Hallock, MN 56728-4215
Mailing address
1010 S Birch Ave
Hallock, MN 56728-4215
Phone (218) 843-2165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R-205070-2 | Other | MN | MINNESOTA RN LICENSE |
| F06141226 | Other | AANPCP |
Other providers in Hallock, MN
- Kittson Memorial Hospital Association
- Kittson Memorial Hospital Association
- Kittson Memorial Hospital Association
- Roland Roy Larter
- McAllen Rutz Eye Clinic PA
- Jalyn Robinson
- Duane P Rutz
- James E Surdy
- Leanne Beth Truedson
- Karen Jean Warner
All providers in Hallock, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.