Individual provider Active NPI

Amanda S Collins, FNP-C

  • Family Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1881960458
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP191008 Issued in ME
Practice address
302 Husson Ave Ste 2
Bangor, ME 04401
Phone
(207) 941-2373
Fax
(207) 941-8803
NPI assigned
Mar 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16605 TN
Family Nurse Practitioner 363LF0000X CNP191008 ME Primary

Addresses

Primary practice location

302 Husson Ave Ste 2
Bangor, ME 04401

Mailing address

43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006

Other practice location 1

302 Husson Ave Ste 2
Bangor, ME 04401
Phone (207) 941-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20190305002931 ME Practitioner - Nurse Practitioner 3678729738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

302 Husson Ave
Bangor, ME 04401-3374
Phone (207) 947-6141

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

925 Union St
Bangor, ME 04401-3051

Hospital & facility affiliations

  • Northern Light Home Care & Hospice Home health agency, So Portland, ME, CCN 207020
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16605TNMDPhysical Therapist
CNP191008MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Mar 3, 2019 Accepting new patients
Eastern Maine Medical Center CurrentSince Mar 3, 2019 Accepting new patients

Locations

302 Husson Ave
Ste 2
Bangor, ME 04401
Phone (207) 941-2373

489 State St
Bangor, ME 04401
Phone (207) 973-8837

43 Whiting Hill Rd
Ste 300
Brewer, ME 04412
Phone (207) 973-5000

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.

Hospital & facility affiliations 3

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1881960458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 HUSSON AVE STE 2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-941-2373",
            "fax_number": "207-941-8803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Husson Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "04401",
            "country_code": "US",
            "telephone_number": "207-941-2373",
            "fax_number": "207-941-8803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "AMANDA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16605",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP191008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.