Amanda Holman, FNP-C, MSN, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

62564 Issued in WV

Practice address

800 Grand Central Mall
Suite 4
Vienna, WV 26105-4100

Phone

(304) 485-3300

Fax

(304) 485-6489

NPI assigned

Jul 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

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

Telehealth

Offers telehealth services

Group practices

Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Camden-Clark Physician Corporation

  • Surgery Physician
  • Parkersburg, WV
  • NPI 1710125430
  Medicare reassignment Care Compare group NPD
• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  NPD (past)

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

• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1508160268
  Care Compare affiliation
• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  Care Compare affiliation

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1982080057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 4",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-485-3300",
            "fax_number": "304-485-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL",
            "address_2": "SUITE 4",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054100",
            "telephone_number": "304-485-3300",
            "fax_number": "304-485-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "AMANDA",
        "credential": "FNP-C, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "303540",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "62564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "62564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142450",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810029780",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce Michael Hietpas, LAT, ATC
• Penny Hill
• Tosha Hill
• Erica Dawn Hillyard, PHARMD
• Ronda Hinzman
• Kelly Lynn Hopkins
• Justin Hornbeck
• Carol Horton
• Dustin Huffman, DDS
• Rebecca Hughes

• Family Nurse Practitioner in Vienna, WV
• Providers in Vienna, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.