Individual provider Active NPI

Amanda C. John, APRN-FNP

  • Family Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1881553253
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1224745 Issued in TX
Practice address
115 S Randolph St Ste 101
San Angelo, TX 76903-6425
Phone
(323) 252-3403
NPI assigned
Jan 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 1224745 TX Primary

Addresses

Primary practice location

115 S Randolph St Ste 101
San Angelo, TX 76903-6425

Mailing address

415 Clover Dr
San Angelo, TX 76903-1104
Phone (323) 252-3403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260205002642 TX Practitioner - Nurse Practitioner 6709365265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Wiseman Family Practice PLLCGroup PAC ID 9739491564, 34 clinicians

Practice addresses (Care Compare)

115 S Randolph St
Suite 101
San Angelo, TX 76903-6425
Phone (325) 617-4583

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1224745TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wiseman Family Practice PLLC CurrentSince Feb 16, 2026 Accepting new patients

Locations

2500 S Lakeline Blvd
Ste 100
Cedar Park, TX 78613
Phone (512) 345-8970

115 S Randolph St
Ste 101
San Angelo, TX 76903
Phone (323) 252-3403

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1881553253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 CLOVER DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769031104",
            "telephone_number": "323-252-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S RANDOLPH ST STE 101",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036425",
            "telephone_number": "323-252-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "AMANDA",
        "middle_name": "C.",
        "credential": "APRN-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1224745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.