Active NPI
Amanda Kaye Vickers, ARNP
- Pediatric Nurse Practitioner
- Oakland, CA
National Provider Identifier
1871926709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 95001590
- Practice address
- 747 52ND St
Oakland, CA 94609-1809 - Phone
- (510) 428-3000
- NPI assigned
- Aug 14, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | ARNP 9283248 | FL | |
| Pediatric Nurse Practitioner | 363LP0200X | 95001590 | CA | Primary |
Addresses
Primary practice location
747 52ND St
Oakland, CA 94609-1809
Mailing address
747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95001590 | CA | MD | Pediatric Nurse Practitioner |
| ARNP 9283248 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telehealth Services USA | Nurse Practitioner | Past | Accepting new patients |
Organizations & group practices 1
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": "1376438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424044800000",
"number": "1871926709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 52ND ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946091809",
"telephone_number": "510-428-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 52ND ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946091809",
"telephone_number": "510-428-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICKERS",
"first_name": "AMANDA",
"middle_name": "KAYE",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-14",
"last_updated": "2015-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP 9283248",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "95001590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.