Amanda Houston Trent, AGACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

902537 Issued in MS

Practice address

4381 S Eason Blvd Ste 203
Tupelo, MS 38801-6557

Phone

(662) 377-5199

Fax

(662) 377-5301

NPI assigned

Jun 28, 2018

Last updated

Jun 28, 2018By 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 MS, KY2 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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  KY, MS

  Medicare reassignment NPD

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1821583196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD.",
            "address_2": "STE. #203",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-377-5199",
            "fax_number": "667-377-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD STE 203",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016557",
            "telephone_number": "662-377-5199",
            "fax_number": "662-377-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENT",
        "first_name": "AMANDA",
        "middle_name": "HOUSTON",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "902537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latrisha Townsend
• Sonya Marie Townsend, FNP
• Stacy Travis
• Raven Traylor, LMSW
• Tandalaya M Traylor, DNP, FNP-C
• Melinda J Trentham, MS
• Tri-Vista Rehab, Inc
• Tri-Vista Rehab, Inc
• Jazzma Trice, FNP
• Kendrick Deon Triplett

• Acute Care Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.