Amanda Folsom, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

903658 Issued in MS

Practice address

340 Stateline Rd W
Southaven, MS 38671-1610

Phone

(662) 985-0625

NPI assigned

Jun 15, 2020

Last updated

Apr 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, CO, KS, IA4 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 4

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Eastern Iowa Health CenterGroup PAC ID 0648364828, 23 clinicians

Kit Carson County Health Services DistrictGroup PAC ID 4385637917, 6 clinicians

Konza Prairie Community Health Center IncGroup PAC ID 3779483466, shared by 3 NPIs, 20 clinicians

Keefe Memorial Health Service DistrictGroup PAC ID 8325364441, shared by 3 NPIs, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.folsom.1@13071.direct.athenahealth.com

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.

• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1578753703
  Medicare reassignment Care Compare group NPD
• Kit Carson County Health Services District

  dba Parke Health Center

  • Rural Health Clinic/Center
  • Burlington, CO
  • NPI 1932211596
  Medicare reassignment Care Compare group NPD
• First Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Olive Branch, MS
  • NPI 1255631610
  Medicare reassignment NPD
• Hospital District No 1 Crawford County

  • Nurse Practitioner
  • Girard, KS
  • NPI 1508897182
  Medicare reassignment NPD
• Keefe Memorial Health Service District

  dba Keefe Memorial Hospital

  • Critical Access Hospital
  • Cheyenne Wells, CO
  • NPI 1366840688
  Medicare reassignment NPD
• Carearc, Inc.

  • Federally Qualified Health Center (FQHC)
  • Emporia, KS
  • NPI 1467413906
  NPD
• Carearc, Inc.

  • Public Health or Welfare Agency
  • Emporia, KS
  • NPI 1760658108
  NPD
• Eastern Iowa Health Center

  dba Eastern Iowa Health Center Pharmacy

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1346048675
  NPD
• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1598216244
  NPD
• Hospital District No 1 Crawford County

  dba Girard Medical Center of Fort Scott

  • Rural Health Clinic/Center
  • Fort Scott, KS
  • NPI 1093426470
  NPD
• Keefe Memorial Health Service District

  dba Prairie View Clinic

  • Rural Health Clinic/Center
  • Cheyenne Wells, CO
  • NPI 1396143574
  NPD
• Keefe Memorial Health Service District

  dba Kit Carson Clinic

  • Rural Health Clinic/Center
  • Kit Carson, CO
  • NPI 1457749608
  NPD

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1851916837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711610",
            "telephone_number": "662-985-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711610",
            "telephone_number": "662-985-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "AMANDA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-83076-121",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "903658",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0004297-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Kathleen Fleming, DO
• Barry T Flippo, PA-C
• Aimee Nicole Floyd, FNP-BC
• Riley Floyd, LPTA
• Focus Sleep Center of Desoto, LLC
• Kristin Schick Fonseca, O.D.
• Christy Fontenot, L.C.S.W.
• Nicole Marie Fontenot, DO
• Daniel B Fore, M.D.
• James Everett Fortune, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.