Individual provider Active NPI

Amanda N Evans, NP

  • Acute Care Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1912284951
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
736872 Issued in TX
Practice address
1900 Mistletoe Blvd Ste 200
Fort Worth, TX 76104-4049
Phone
(817) 878-5333
Fax
(817) 878-5334
NPI assigned
Nov 4, 2011
Last updated
Feb 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 736872 TX Primary

Addresses

Primary practice location

1900 Mistletoe Blvd Ste 200
Fort Worth, TX 76104-4049

Mailing address

1900 Mistletoe Blvd Ste 200
Fort Worth, TX 76104-4049
Phone (817) 878-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20121015000409 TX Practitioner - Nurse Practitioner 3173773884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Worth Brain and Spine Institute, LLPGroup PAC ID 0840273868, 11 clinicians

Practice addresses (Care Compare)

1900 Mistletoe Blvd
Suite 200
Fort Worth, TX 76104-4049
Phone (817) 878-5333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
736872TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Oct 1, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 1, 2023 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Fort Worth Brain & Spine Institute, LLP CurrentSince Nov 1, 2012 Accepting new patients

Locations

829 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 558-4600

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

1900 Mistletoe Blvd
Ste 200
Ft Worth, TX 76104

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: aevans459210@direct.sw.org
  • Direct secure messaging: amanda.evans@hca7.eclinicaldirectplus.com

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 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": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1912284951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MISTLETOE BLVD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044049",
            "telephone_number": "817-878-5333",
            "fax_number": "817-878-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MISTLETOE BLVD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044049",
            "telephone_number": "817-878-5333",
            "fax_number": "817-878-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "AMANDA",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "736872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.