Active NPI
Amanda J Fruen, DNP, APRN,FNP-BC
- Nurse Practitioner
- Rockford, IL
National Provider Identifier
1952941833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 235950
- Practice address
- 816 Featherstone Rd
Rockford, IL 61107-6300 - Phone
- (815) 227-0081
- NPI assigned
- Jan 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 235950 | AZ | Primary |
Addresses
Primary practice location
816 Featherstone Rd
Rockford, IL 61107-6300
Mailing address
618 Featherstone Rd
Rockford, IL 61107-1944
Phone (815) 227-0081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200409001519 | WI | Order and Referring Only - Nurse Practitioner | 1153750328 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1952941833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 FEATHERSTONE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611071944",
"telephone_number": "815-227-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 FEATHERSTONE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611076300",
"telephone_number": "815-227-0081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRUEN",
"first_name": "AMANDA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DNP, APRN,FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-08",
"last_updated": "2020-10-09",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "235950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.