Amanda Shea Phillips, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN239312 Issued in GA

Practice address

303 Harris Industrial Blvd Ste 3
Vidalia, GA 30474-8854

Phone

(912) 537-9355

NPI assigned

Oct 9, 2024

Last updated

Oct 9, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• VPC, Inc.

  dba Vidalia Pediatric Clinic

  • Pediatrics Physician
  • Vidalia, GA
  • NPI 1710043237
  NPD (past)

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1972322691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W 7TH ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD STE 3",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748854",
            "telephone_number": "912-537-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "AMANDA",
        "middle_name": "SHEA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN239312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Peery, RPH
• Peterson Dermatology, P.C.
• Letty Revell Peterson, M.D.
• Phillips Drugs, Inc (Phillips Pharmacy)
• Phillips Drugs, Inc (Phillips Pharmacy (LTC))
• Andrea Phillips
• Annilyne Michele Phillips, RPH
• Kimberly Nichole Phillips, FNP-C
• Macey Alexis Phillips
• Alex Pierce, PA

• Family Nurse Practitioner in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.