Individual provider Active NPI

Amanda Lynn Halvorson, NP

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1891294195
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209016873 Issued in IL
Practice address
5970 Churchview Dr
Rockford, IL 61107-2574
Phone
(815) 971-2000
NPI assigned
Feb 2, 2018
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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 209016873 IL Primary
General Practice Physician 208D00000X 209016873 IL

Addresses

Primary practice location

5970 Churchview Dr
Rockford, IL 61107-2574

Mailing address

3456 N Farwell Bridge Rd
Rock City, IL 61070-9783

Other identifiers 1

IdentifierTypeStateIssuer
1891294195MedicaidWI

Other names 1

  • Amanda Lynn Mundinger Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180308000009 IL Practitioner - Nurse Practitioner 4082975032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400

1625 S State St
Belvidere, IL 61008-5907

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians Single Specialty CurrentSince Feb 1, 2018 Accepting new patients
RMH Pathologists, LTD Single Specialty Current Accepting new patients
Swedishamerican Hospital CurrentSince Apr 19, 2022 Accepting new patients
Swedishamerican Hospital Single Specialty CurrentSince Apr 19, 2022 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1415 E State St
Ste 100
Rockford, IL 61104

2300 N Rockton Ave
Rockford, IL 61103

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

5970 Churchview Dr
Rockford, IL 61107
Phone (815) 971-8990

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1891294195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 N FARWELL BRIDGE RD",
            "city": "ROCK CITY",
            "state": "IL",
            "postal_code": "610709783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 CHURCHVIEW DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072574",
            "telephone_number": "815-971-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2026-09-29",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209016873",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "209016873",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891294195",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MUNDINGER",
            "middle_name": "LYNN",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.