Individual provider Active NPI

Amanda S Savage, FNP

  • Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1871865717
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R868540 Issued in MS
Practice address
3495 Cobblestone Blvd S
Southaven, MS 38672-7075
Phone
(662) 892-2885
Fax
(662) 890-1551
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R868540 MS Primary
Nurse Practitioner 363L00000X APN0000016413 TN

Addresses

Primary practice location

3495 Cobblestone Blvd S
Southaven, MS 38672-7075

Mailing address

3495 Cobblestone Blvd S
Southaven, MS 38672-7075
Phone (662) 892-2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20120326000022 MS Practitioner - Nurse Practitioner 5890955132 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R868540MSMDNurse Practitioner
APN0000016413TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Family Wellness Center, LLC CurrentSince Mar 21, 2022 Accepting new patients
Associated Family Medical, LLC Nurse Practitioner Current Accepting new patients
Archipoimen PLLC CurrentSince Dec 13, 2024 Accepting new patients

Locations

2670 McIngvale Rd
Ste H
Hernando, MS 38632
Phone (662) 429-4988

2416 Mount Pleasant Rd
Hernando, MS 38632
Phone (662) 298-3181

Interoperability endpoints

  • Direct secure messaging: amanda.savage.1@17263.direct.athenahealth.com

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1871865717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 COBBLESTONE BLVD S",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727075",
            "telephone_number": "662-892-2885",
            "fax_number": "662-890-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 COBBLESTONE BLVD S",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727075",
            "telephone_number": "662-892-2885",
            "fax_number": "662-890-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVAGE",
        "first_name": "AMANDA",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R868540",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000016413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.