Individual provider Active NPI

Amanda Deatherage, APRN-CNP

  • Family Nurse Practitioner
  • Lovington, NM
National Provider Identifier
1902551005
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
67588 Issued in NM
Practice address
1600 W Avenue I
Lovington, NM 88260-5002
Phone
(806) 928-9870
Fax
(806) 243-6233
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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 1070110 TX
Family Nurse Practitioner 363LF0000X 67588 NM Primary

Addresses

Primary practice location

1600 W Avenue I
Lovington, NM 88260-5002

Mailing address

901 W Wildy St
Roswell, NM 88203-3717
Phone (806) 928-9870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20220809000212 NM Practitioner - Nurse Practitioner 3274915186 Reassigns benefits to 2 organizations
I20221219001630 TX Practitioner - Nurse Practitioner 3274915186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cura HealthcareGroup PAC ID 5799143103, 81 clinicians

Practice addresses (Care Compare)

Albuquerque, NM 87110
Phone (505) 413-3719

Hospital & facility affiliations

  • Nor-Lea Hospital District Hospital, Lovington, NM, CCN 321305
  • Eastern New Mexico Medical Center Hospital, Roswell, NM, CCN 320006
  • University Medical Center Hospital, Lubbock, TX, CCN 450686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67588NMMDFamily Nurse Practitioner
1070110TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District CurrentSince Sep 3, 2025 Accepting new patients
Cura Healthcare Family Medicine CurrentSince Feb 1, 2024 Accepting new patients

Locations

8226 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 413-3719

1600 W Avenue I
Lovington, NM 88260
Phone (575) 396-5212

11011 Slide Rd
Lubbock, TX 79424
Phone (806) 743-2584

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

7683 SE 27th St
Mercer Island, WA 98040
Phone (206) 228-8530

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1902551005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W WILDY ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882033717",
            "telephone_number": "806-928-9870",
            "fax_number": "806-243-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W AVENUE I",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882605002",
            "telephone_number": "806-928-9870",
            "fax_number": "806-243-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATHERAGE",
        "first_name": "AMANDA",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1070110",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "67588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovington, NM

Sources for this page

Verify at the official NPI Registry.