Individual provider Active NPI

Amanda Fuson, APRN, FNP-C

  • Family Nurse Practitioner
  • Louisville, IL
National Provider Identifier
1821746678
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024886 Issued in IL
Practice address
850 Bryant St
Louisville, IL 62858-1000
Phone
(618) 665-7000
NPI assigned
Mar 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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 209024886 IL Primary

Addresses

Primary practice location

850 Bryant St
Louisville, IL 62858-1000

Mailing address

850 Bryant St
Louisville, IL 62858-1000
Phone (618) 665-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220329002391 IL Practitioner - Nurse Practitioner 9133515257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Trinity Health and Wellness LLCGroup PAC ID 9537420724, 5 clinicians

Practice addresses (Care Compare)

850 Bryant St
Louisville, IL 62858-1000
Phone (618) 665-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209024886ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health and Wellness, LLC. CurrentSince Mar 9, 2022 Accepting new patients
Trinity Health and Wellness, LLC. Family CurrentSince Mar 9, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17274/brand/1/csg/1/fhir/r4
  • Direct secure messaging: amanda.fuson.1@17274.direct.athenahealth.com

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 5

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": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1821746678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BRYANT ST",
            "city": "LOUISVILLE",
            "state": "IL",
            "postal_code": "628581000",
            "telephone_number": "618-665-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BRYANT ST",
            "city": "LOUISVILLE",
            "state": "IL",
            "postal_code": "628581000",
            "telephone_number": "618-665-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSON",
        "first_name": "AMANDA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, IL

Sources for this page

Verify at the official NPI Registry.