Amanda Stagg

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4015968 Issued in KY

Practice address

828 Lane Allen Rd Ste 219
Lexington, KY 40504-3659

Phone

(260) 483-9081

NPI assigned

Dec 4, 2023

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

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kentucky Counseling Center LLCGroup PAC ID 7618221300, 57 clinicians

Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Eventus Wholehealth Midwest IncGroup PAC ID 4183040470, 120 clinicians

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Kentucky Counseling Center, LLC

  • Counselor
  • Louisville, KY
  • NPI 1932590338

  IN

  Medicare reassignment Care Compare group NPD
• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  KY

  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth Midwest Inc

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1386252757

  KY

  Medicare reassignment Care Compare group NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  KY

  Medicare reassignment Care Compare group NPD
• Eventus Ecs - Kentucky, PLLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1396563276

  IN

  Medicare reassignment NPD
• Eventus WH Midwest Care, LLC

  • Nurse Practitioner
  • Concord, NC
  • NPI 1588481717

  IN, KY

  Medicare reassignment NPD
• Extended Care Specialists, Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1669873733
  NPD (past)

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1891561585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 OAK GROVE RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152342",
            "telephone_number": "620-566-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 LANE ALLEN RD STE 219",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043659",
            "telephone_number": "260-483-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGG",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28236174A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4015968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Stafford, APRN
• Reagan Michelle Stafford, MD
• Rebekah Lorraine Stafford, M.D.
• William Lane Stafford, MD
• Angel M Stager
• Mollie Staggs, LCSW
• Kelly Ann Stahl, MD
• Gregory Vernon Stahr, DMD
• Jeffrey David Stahr, DMD
• Jill Allison Stahr, M.ED-IECE

• Psychiatric/Mental Health Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.