Individual provider Active NPI

Amanda Librizzi Muth, DNP

  • Pediatric Nurse Practitioner
  • Moncks Corner, SC
National Provider Identifier
1821865403
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
27671 Issued in SC
Practice address
5000 Epson Plantation Dr
Moncks Corner, SC 29461-3979
Phone
(843) 761-2000
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 27671 SC Primary

Addresses

Primary practice location

5000 Epson Plantation Dr
Moncks Corner, SC 29461-3979

Mailing address

PO Box 751461
Charlotte, NC 28275-1461

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DIRECT@DIRECT.MUSC.EDU Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240112001635 SC Practitioner - Nurse Practitioner 6103277223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27671SCMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Dec 18, 2023 Accepting new patients
Carolina Family Care, Inc CurrentSince Dec 18, 2023 Accepting new patients
Sweetgrass Pediatrics Past Accepting new patients

Locations

5000 Epson Plantation Dr
Moncks Corner, SC 29461
Phone (843) 761-2000

5000 Epson Plantation Dr
Ste B
Moncks Corner, SC 29461
Phone (843) 754-4801

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

Interoperability endpoints

  • Direct secure messaging: direct@direct.musc.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1821865403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 EPSON PLANTATION DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613979",
            "telephone_number": "843-761-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTH",
        "first_name": "AMANDA",
        "middle_name": "LIBRIZZI",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "27671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DIRECT@DIRECT.MUSC.EDU",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5000 Epson Plantation Dr",
            "city": "Moncks Corner",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294613979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

Verify at the official NPI Registry.