Amanda Reynolds, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209012925 Issued in IL

Practice address

1006 S Division St
Carterville, IL 62918-1539

Phone

(618) 519-9200

NPI assigned

Jul 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawnee Health Service and Development CorpGroup PAC ID 1658285671, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health of Southern Illinois, LLC Home health agency, Marion, IL, CCN 147112
• LHC-Illinois Home Health Care Home health agency, Marion, IL, CCN 147716
• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184
• Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
• St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.reynolds.2@14668.direct.athenahealth.com

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.

• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carterville, IL
  • NPI 1639295314
  Medicare reassignment Care Compare group NPD
• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1073745345
  NPD
• Shawnee Health Service and Development Corp

  • Community/Retail Pharmacy
  • Carbondale, IL
  • NPI 1760253447
  NPD
• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carterville, IL
  • NPI 1811928732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Regional Healthcare Services Illinois Inc

  • General Acute Care Hospital
  • Marion, IL
  • NPI 1750007266
  Care Compare affiliation
• Harrisburg Medical Center Inc

  • General Acute Care Hospital
  • Harrisburg, IL
  • NPI 1073580130
  Care Compare affiliation
• LHCG Xxxvii, LLC

  • Home Health Agency
  • Marion, IL
  • NPI 1740527407
  Care Compare affiliation
• Residential Home Health of Southern Illinois, LLC

  • Home Health Agency
  • Marion, IL
  • NPI 1235556838
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • Critical Access Hospital
  • Murphysboro, IL
  • NPI 1356435135
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1952785222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA STREET",
            "address_2": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-985-8221",
            "fax_number": "618-985-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S DIVISION ST",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181539",
            "telephone_number": "618-519-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-687-3418",
            "fax_number": "618-687-1859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "AMANDA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209012925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209012925",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.reynolds.2@14668.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1006 S Division St",
            "city": "Carterville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629181539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Progress Port, Inc.
• R&M Phillips Investments, LLC - Herrin MC Operations Series
• Donald Ramsey, BA
• Lisa Rath, BS
• Lauren Reedy, CD(DONA)
• Debora Rich, LCSW
• Tommye L Robb, CCC/SLP
• Nicholas P Robertson, DNP, APRN, FNP-C
• Anna Rose Rodgers
• Patricia Roebuck, LMHC

• Nurse Practitioner in Carterville, IL
• Providers in Carterville, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.