NPIMap

Individual provider Active NPI

Christina Lynn Amendolare, AGPCNP

  • Gerontology Nurse Practitioner
  • Coupeville, WA
National Provider Identifier
1952963829
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024177796 Issued in VA
Practice address
101 N Main St
Coupeville, WA 98239-3413
Phone
(757) 572-9223
Fax
(360) 678-7621
NPI assigned
Jul 1, 2019
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024177796 VA Primary

Addresses

Primary practice location

101 N Main St
Coupeville, WA 98239-3413

Mailing address

101 N Main St
Coupeville, WA 98239-3413
Phone (360) 678-7656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230913004368 WA Practitioner - Nurse Practitioner 9436481389 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Virginia Commonwealth University, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5486 Harbor Ave
Freeland, WA 98249-3002
Phone (360) 678-0831

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey Island Public Hospital District CurrentSince Oct 9, 2023 Accepting new patients
WGH Primary Care Associates, P.S. Current Accepting new patients
Whidbey Island Public Hospital District CurrentSince Oct 9, 2023 Accepting new patients
Whidbey Island Public Hospital District Current Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients

Locations

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

77 N Main St
Coupeville, WA 98239
Phone (360) 678-0831

5486 Harbor Ave
Freeland, WA 98249
Phone (360) 331-5060

275 SE Cabot Dr
Ste B101
Oak Harbor, WA 98277
Phone (360) 675-6648

Interoperability endpoints

  • Direct secure messaging: christina.amendolare@wh.jhie.net

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1952963829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393413",
            "telephone_number": "360-678-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393413",
            "telephone_number": "757-572-9223",
            "fax_number": "360-678-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENDOLARE",
        "first_name": "CHRISTINA",
        "middle_name": "LYNN",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024177796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.