AMANDA SHAWN WHITAKER (NPI# 1295235331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295235331 |
| Entity Type | Individual |
| Full Name | AMANDA SHAWN WHITAKER |
| Credential | FNP-C |
| Practice Address |
675 Highway 62 E Mountain Home AR 72653-3207 |
| Practice Telephone | 8705087600 |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2019-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
902479 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
A005997 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS BLUE SHIELD OF ARKANSAS | 5EA99 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1050 River Oaks Dr Ste 200, Flowood, MS 392329564 | 6014200134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669720579 | Amanda Jo Whitaker | Occupational Therapist | 118 Medical Dr, Carmel, IN 46032-2923 | 2012-08-27 |
| 1629326665 | Amanda Johnson Whitaker | Pharmacist | 109 W Manning St, Chesnee, SC 29323-1538 | 2012-08-23 |
| 1770866188 | Amanda Whitaker | Pharmacist | 2015 Pepperell Pkwy, Opelika, AL 36801-5441 | 2011-09-21 |
| 1700111887 | Amanda Tencza Whitaker | Orthopaedic Surgery | 700 Childrens Dr, Columbus, OH 43205-2664 | 2009-10-07 |
| 1720217227 | Amanda Elizabeth Whitaker | Physical Therapist | 1220 Laguna St, Kokomo, IN 46902-2330 | 2009-07-07 |
| Street Address |
675 HIGHWAY 62 E |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-3207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760426746 | John T Leslie | Family Medicine | 675 Highway 62 E, Mountain Home, AR 72653-3207 | 2006-06-16 |
| 1427514538 | Kirsten Anne Peterson | Nurse Practitioner | 675 Highway 62 E, Mountain Home, AR 72653-3207 | 2019-02-13 |
| 1235589748 | Brittney Woodward Frisby | Family Medicine | 675 Highway 62 E, Mountain Home, AR 72653-3207 | 2016-06-15 |
| 1215341656 | Benjamin Stevens | Family Medicine | 675 Highway 62 E, Mountain Home, AR 72653-3207 | 2014-06-13 |
| 1356464838 | Lonnie M. Hammonds | Dermatology | 675 Highway 62 E, Suite 1, Mountain Home, AR 72653-3207 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396797767 | Karen Lucille Welch | Nurse Practitioner | Building 160 Dogwood Ave, Mountain Home, TN 37684-4000 | 2006-05-16 |
| 1154930402 | Alysa C Werkheiser-quillen | Nurse Practitioner | Sidney and Lamont Streets, Mountain Home, TN 37684 | 2020-07-23 |
| 1306299847 | Christina Ann Craft | Nurse Practitioner | 809 Lamont St, Mountain Home, TN 37684 | 2016-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611361 | Jamie L Cagle | Nurse Practitioner | 1500 Dodson Ave # 60, Fort Smith, AR 72901-5182 | 2020-02-21 |
| 1306489281 | Lawana Bradley | Nurse Practitioner | 296 Lake Rd, Atkins, AR 72823-7165 | 2019-10-23 |
| 1679116024 | Michelle Grant | Nurse Practitioner | 130 Mark Cir, Monticello, AR 71655-5617 | 2019-10-17 |
| 1780238782 | Chelsea D. Marquis | Nurse Practitioner | 4401 Sw Flagstone Blvd, Bentonville, AR 72713-4005 | 2019-07-29 |
| 1265094478 | Kristyn Clark | Nurse Practitioner | 210 S Thompson St, Springdale, AR 72764-4239 | 2019-07-08 |
| 1184194029 | Stephanie Lucille Converse | Nurse Practitioner | 326 Lee Rd # 601, Brickeys, AR 72320-8000 | 2018-12-04 |
| 1174026165 | Phoebe Grace Chandler | Nurse Practitioner | 3782 Solitude St, Springdale, AR 72764-6368 | 2018-03-15 |
| 1386143717 | Andrew Freeman Oliver | Nurse Practitioner | 650 United Dr Ste 200, Conway, AR 72032-7001 | 2018-02-12 |
| 1760908982 | Jamie Leigh Ferguson | Nurse Practitioner | 4301 W Markham St # 721-3, Little Rock, AR 72205-7101 | 2017-08-18 |
| 1336677731 | Robert Lee Mcgruder Jr. | Nurse Practitioner | 2308 Royal Ct Unit B, Bryant, AR 72022-4216 | 2017-05-30 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on AMANDA SHAWN WHITAKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.