Amber Reagan Carter, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1112215 Issued in TX

Practice address

1100 N Kimball Ave Ste 110
Southlake, TX 76092-4726

Phone

(817) 251-7995

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Avalyn Wellness and Ketamine LLC

  • Multi-Specialty Clinic/Center
  • Southlake, TX
  • NPI 1356036933

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1942905765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SHORELINE RIDGE DR",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750681722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N KIMBALL AVE STE 110",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924726",
            "telephone_number": "817-251-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "AMBER",
        "middle_name": "REAGAN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1112215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Carr, PT, DPT
• Clarisvel Carranco
• Thomas M Carrell, MD
• Benjamin Carroll, PT, DPT
• Carrus Behavioral Hospital LLC
• Cameron Samuel Carter, DMD
• Warren Leslie Carter, PHD
• Stacey Cartlidge, M.ED., LPC
• Camille Michelle Carwell
• Joseph Steven Casaly, M.D.

• Nurse Practitioner in Southlake, TX
• Providers in Southlake, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.