Individual provider Active NPI

Amanda M Bryant

  • Family Nurse Practitioner
  • Wilbraham, MA
National Provider Identifier
1912436619
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2294531 Issued in MA
Practice address
70 PST Office Park
Wilbraham, MA 01095
Phone
(413) 598-7770
NPI assigned
Jun 6, 2017
Last updated
Dec 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2294531 MA Primary

Addresses

Primary practice location

70 PST Office Park
Wilbraham, MA 01095

Mailing address

70 Post Office Park
Wilbraham, MA 01095-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20171012001662 MA Practitioner - Nurse Practitioner 5496020760 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2294531MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Sep 1, 2017 Accepting new patients
Riverbend Medical Group, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Mwa,PC Past Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients

Locations

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

395 Southampton Rd
Ste 100
Westfield, MA 01085
Phone (413) 485-4661

70 Post Office Park
Wilbraham, MA 01095
Phone (413) 598-7770

Interoperability endpoints

  • Direct secure messaging: abryant2389676@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1912436619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 POST OFFICE PARK",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PST OFFICE PARK",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "01095",
            "telephone_number": "413-598-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "AMANDA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2294531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilbraham, MA

Sources for this page

Verify at the official NPI Registry.