Individual provider Active NPI

Amanda Dawn Boone, FNP

  • Family Nurse Practitioner
  • Dover, DE
National Provider Identifier
1962922997
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0001047 Issued in DE
Practice address
33 Gooden Ave
Dover, DE 19904-4143
Phone
(302) 678-9355
Fax
(302) 678-9310
NPI assigned
Jun 21, 2017
Last updated
May 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0001047 DE Primary

Addresses

Primary practice location

33 Gooden Ave
Dover, DE 19904-4143

Mailing address

33 Gooden Ave
Dover, DE 19904-4143
Phone (302) 678-9355

Other names 1

  • Amanda Dawn Blackwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20170811000136 DE Practitioner - Nurse Practitioner 6204107196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
It Is Well Healthcare, LLCGroup PAC ID 2961897053, 4 clinicians

Practice addresses (Care Compare)

33 Gooden Ave
Dover, DE 19904-4143
Phone (302) 678-9355

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
It Is Well Healthcare, LLC Family CurrentSince Feb 7, 2022 Accepting new patients
Family Allergy & Asthma Care Consultants LLC CurrentSince Jun 27, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

103 Wolf Creek Blvd
Ste 1
Dover, DE 19901
Phone (302) 674-2420

200 Banning St
Ste 280
Dover, DE 19904
Phone (302) 734-4434

33 Gooden Ave
Dover, DE 19904
Phone (302) 678-9355

Organizations & group practices 3

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 3

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1962922997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GOODEN AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044143",
            "telephone_number": "302-678-9355",
            "fax_number": "302-678-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 GOODEN AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044143",
            "telephone_number": "302-678-9355",
            "fax_number": "302-678-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0001047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BLACKWELL",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.