Amanda Elizabeth Tritt, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R867404 Issued in MS

Practice address

101 Ricky D Britt Sr Blvd # 2
Oxford, MS 38655-9103

Phone

(662) 236-5442

Fax

(662) 236-5295

NPI assigned

Aug 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda Wilbourn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Mississippi PHS PC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1326278615
  NPD (past)

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861623027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RICKY D BRITT SR BLVD # 2",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559103",
            "telephone_number": "662-236-5442",
            "fax_number": "662-236-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RICKY D BRITT SR BLVD # 2",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559103",
            "telephone_number": "662-236-5442",
            "fax_number": "662-236-5295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Sunset Dr Ste Q",
            "address_purpose": "LOCATION",
            "city": "Grenada",
            "state": "MS",
            "postal_code": "389014084",
            "country_code": "US",
            "telephone_number": "662-294-9101",
            "fax_number": "662-294-9104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRITT",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R867404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03956051",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WILBOURN",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Oxford, MS
• Providers in Oxford, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.