Individual provider Active NPI

Amanda Wright, DO

  • Family Medicine Physician
  • Barling, AR
National Provider Identifier
1942404884
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02005622A Issued in IN
Practice address
7003 Chad Colley Blvd
Barling, AR 72923-3000
Phone
(479) 431-3500
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-10571 AR
Student in an Organized Health Care Education/Training Program 390200000X 125053539 IL
Family Medicine Physician 207Q00000X 02005622A IN Primary

Addresses

Primary practice location

7003 Chad Colley Blvd
Barling, AR 72923-3000

Mailing address

8414 Naab Rd
Indianapolis, IN 46260-1972

Other practice location 1

815 Main St
Peoria, IL 61602-1076
Phone (309) 672-4977

Other practice location 2

8414 Naab Rd
Indianapolis, IN 46260-1972
Phone (317) 338-7510

Other identifiers 1

IdentifierTypeStateIssuer
1942404884MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220513002159 IN Practitioner - Family Practice 4880732213 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-10571ARMDFamily Medicine Physician
125053539ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Jun 20, 2022 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Family Medicine CurrentSince Jun 20, 2022 Accepting new patients

Locations

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

8414 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-1600

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1942404884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 CHAD COLLEY BLVD",
            "city": "BARLING",
            "state": "AR",
            "postal_code": "729233000",
            "telephone_number": "479-431-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Main St",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616021076",
            "country_code": "US",
            "telephone_number": "309-672-4977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8414 Naab Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601972",
            "country_code": "US",
            "telephone_number": "317-338-7510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-10571",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125053539",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005622A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942404884",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barling, AR

Sources for this page

Verify at the official NPI Registry.