Amanda Grange, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

851794 Issued in NV

Practice address

2600 S Decatur Blvd
Las Vegas, NV 89102-8519

Phone

(702) 877-5199

NPI assigned

Mar 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Hudson Former name

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agrange161243@westdirect.optum.com

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.

• Optum Medical Group II Rhodes P C

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407
  Medicare reassignment Care Compare group NPD
• Iriye Medical Group PLLC

  • Maternal & Fetal Medicine Physician
  • Las Vegas, NV
  • NPI 1467496240
  Medicare reassignment NPD
• Optum Medical Group Rhodes P C

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1770556037
  NPD

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1891445698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028519",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGE",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "851794",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "851794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HUDSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas Enrico Grande, RPH
• Dashawn Tony Granderson
• La'Nayja Dae'Marie Granderson
• John Granell Jr.
• Granepps LLC
• Kelsey Granger, PA
• Brandon Granil, APRN
• Nancy Granillo-Anaya
• Melizza Granillo
• Granite Sahara Surgical Center, LLC

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.