Individual provider Active NPI

Amanda Rogers Smith, CRNP

  • Nurse Practitioner
  • Northport, AL
National Provider Identifier
1821387069
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-107916 Issued in AL
Practice address
2700 Hospital Dr
Northport, AL 35476-3360
Phone
(205) 344-9019
Fax
(205) 344-9031
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-107916 AL Primary

Addresses

Primary practice location

2700 Hospital Dr
Northport, AL 35476-3360

Mailing address

2330 University Blvd
Ste 501
Tuscaloosa, AL 35401-1599
Phone (205) 344-9019

Other names 1

  • Amanda Rogers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20130920000557 AL Practitioner - Nurse Practitioner 2365686938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Relias Emergency Medicine Specialists of Northport, LLCGroup PAC ID 2668724634, 22 clinicians

Practice addresses (Care Compare)

2700 Hospital Dr
Northport, AL 35476-3360
Phone (205) 333-4500

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-107916ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Nurse Practitioner CurrentSince Apr 1, 2014 Accepting new patients
Relias Emergency Medicine Specialists of Northport, LLC CurrentSince Sep 1, 2018 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Organizations & group practices 2

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.

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1821387069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 UNIVERSITY BLVD",
            "address_2": "STE 501",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011599",
            "telephone_number": "205-344-9019",
            "fax_number": "205-344-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-344-9019",
            "fax_number": "205-344-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "ROGERS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-107916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ROGERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.