Amanda Lively, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7946150-4405 Issued in UT

Practice address

377 N Fairgrounds Rd
Price, UT 84501-4241

Phone

(435) 613-2200

Fax

(435) 613-2201

NPI assigned

Feb 23, 2016

Last updated

May 17, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Shane D Gagon MD, PCGroup PAC ID 9335236868, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Castleview Hospital Hospital, Price, UT, CCN 460011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mru8593@yourcarecommunity.org

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.

• Shane D Gagon MD, PC

  dba Castle Country Family Medicine

  • Family Medicine Physician
  • Price, UT
  • NPI 1982815064
  Medicare reassignment Care Compare group NPD

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

• Castleview Hospital LLC

  dba Castleview Hospital

  • Rural Acute Care Hospital
  • Price, UT
  • NPI 1417064205
  Care Compare affiliation

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1982064622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1437",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845011437",
            "telephone_number": "435-613-2200",
            "fax_number": "435-613-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 N FAIRGROUNDS RD",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014241",
            "telephone_number": "435-613-2200",
            "fax_number": "435-613-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 N Main St",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "UT",
            "postal_code": "845285512",
            "country_code": "US",
            "telephone_number": "435-613-2200",
            "fax_number": "435-613-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "AMANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130221",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7946150-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bradford Lewis, DPT
• Amber I Liin
• Lin's Supermarkets Inc
• Lincare Inc.
• Emma Oradell Littlejohn, LCSW
• Mason Geral Livingston, O.D.
• Kaylee Love
• Bret K Lowe, DDS, PC
• Carma Josie Luke
• Erik Mackinnon Lyman, M.D.

• Family Nurse Practitioner in Price, UT
• Providers in Price, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.