Active NPI
Amanda Durr, LSW
- Social Worker
- Sparta, IL
National Provider Identifier
1821676164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.104216
- Practice address
- 104 Northtown Rd
Sparta, IL 62286-1081 - Phone
- (618) 282-6233
- NPI assigned
- Mar 30, 2021
- Last updated
- Mar 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.104216 | IL | Primary |
Addresses
Primary practice location
104 Northtown Rd
Sparta, IL 62286-1081
Mailing address
10257 State Route 3
Red Bud, IL 62278-4418
Phone (618) 282-6233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.104216 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1821676164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10257 STATE ROUTE 3",
"city": "RED BUD",
"state": "IL",
"postal_code": "622784418",
"telephone_number": "618-282-6233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 NORTHTOWN RD",
"city": "SPARTA",
"state": "IL",
"postal_code": "622861081",
"telephone_number": "618-282-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURR",
"first_name": "AMANDA",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-30",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.104216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparta, IL
- Deaconess Illinois Specialty Clinic, Inc. (Deaconess IL Specialty Broadway St)
- Deaconess Illinois Specialty Clinic, Inc. (Deaconess IL Specialty Burns Ave)
- Alisa D Dearmond, APRN
- Andra Marie Dehn
- Jennifer Adele Demsar, APRN
- Ashley Suzanne Eggemeyer, MS CFY-SLP/L
- Empowerme Rehabilitation Illinois, LLC
- Amy Eppstein, M.D.
- Anthony James Fair, MA QMHP
- Edward P Feutz, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.