Individual provider Active NPI

Amanda L McDonald, APRN, CNP

  • Family Nurse Practitioner
  • Washington, IL
National Provider Identifier
1851932040
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209019127 Issued in IL
Practice address
10 Saint Clare CT Ste 100
Washington, IL 61571-9239
Phone
(309) 886-4000
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 209019127 IL Primary

Addresses

Primary practice location

10 Saint Clare CT Ste 100
Washington, IL 61571-9239

Mailing address

128 Field Grove CT
East Peoria, IL 61611-4323
Phone (309) 634-8404

Other names 1

  • Amanda L Hamlet Former name

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
I20191031001741 IL Practitioner - Nurse Practitioner 9436481025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

10 Saint Clare CT
Washington, IL 61571-9239
Phone (309) 886-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209019127ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Nov 4, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

928 W Mount Vernon St
Metamora, IL 61548
Phone (309) 367-2229

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

10 Saint Clare Ct
Washington, IL 61571
Phone (309) 886-4000

10 Saint Clare Ct
Ste 100
Washington, IL 61571
Phone (309) 886-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1851932040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FIELD GROVE CT",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114323",
            "telephone_number": "309-634-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SAINT CLARE CT STE 100",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719239",
            "telephone_number": "309-886-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HAMLET",
            "middle_name": "L",
            "credential": "APRN, CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, IL

Sources for this page

Verify at the official NPI Registry.