MRS. AMANDA DEWITT REYNOLDS (NPI# 1194266023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194266023 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA DEWITT REYNOLDS |
| Credential | FNP-BC |
| Practice Address |
4222 Long Beach Rd Se Southport NC 28461-8627 |
| Mailing Address |
924 N Howe St Southport NC 28461-3038 |
| Practice Telephone | 9104544732 |
| Practice Fax Number | 9104779234 |
| Mailing Telephone | 9104573808 |
| Mailing Fax Number | 9104573842 |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2019-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5009418 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5131 Ocean Hwy E, Winnabow, NC 284795445 | 9102337744 | |
| 823 N Atlantic Ave, Southport, NC 284613531 | 9104579292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982243655 | Amanda Reynolds | Pharmacist | 6929 Jfk Blvd Ste 5, North Little Rock, AR 72116-5397 | 2019-12-30 |
| 1861830549 | Amanda M Reynolds | Marriage & Family Therapist | 9006 Leeland Archer Blvd, Orlando, FL 32836-8838 | 2013-06-04 |
| 1922304658 | Amanda Michelle Reynolds | Community Health Worker | 2138 Se Maryland Ave, Topeka, KS 66605-1338 | 2011-01-27 |
| 1841222791 | Amanda L Reynolds | Pharmacist | 173 Market St, Potsdam, NY 13676-1221 | 2006-07-07 |
| 1710591755 | Amanda Reynolds | Social Worker | 4 Forest Ave, Paramus, NJ 07652-5237 | 2020-09-08 |
| 1780293225 | Amanda Lee Reynolds | Technician | 1 Avenue C Ste 110, Madison, WV 25130-1100 | 2020-07-30 |
| 1821626334 | Amanda Melece Reynolds | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-03-30 |
| 1710427992 | Amanda Reynolds | Military Hospital | 520 9th St, Slidell, LA 70458-1416 | 2017-03-07 |
| 1952785222 | Amanda Reynolds | Nurse Practitioner | 1006 S Division St, Carterville, IL 62918-1539 | 2015-07-16 |
| 1447637426 | Amanda Reynolds | Social Worker | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2015-04-29 |
| Street Address |
4222 LONG BEACH RD SE |
| City | SOUTHPORT |
| State | NC |
| Zip Code | 28461-8627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942232665 | Karen Harris Chance | Nurse Practitioner | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2006-07-06 |
| 1568887818 | J. Arthur Dosher Memorial Hospital | Clinic/Center | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2014-02-24 |
| 1942579339 | Med First Immediate Care & Family Practice, Pa | Clinic/Center | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2011-12-14 |
| 1326350190 | Wilmington Health Pllc | Internal Medicine | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2010-07-09 |
| 1700112489 | Boss Urgent Care Pllc | Clinic/Center | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2009-10-30 |
| 1073770939 | Atlantic Urology PC | Urology | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2008-05-19 |
| 1316124845 | John Delamar Schoonmaker | Physician Assistant | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2008-01-28 |
| 1215005459 | Michael Cahn | Surgery | 4222 Long Beach Rd Se, Southport, NC 28461-8627 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645542 | Island Time Medical and Wellness, Pllc | Clinic/Center | 39 Dowitcher Trl, Bald Head Island, NC 28461 | 2020-09-30 |
| 1871095356 | Sunny Point Fire & Rescue | Emergency Medicine | 6280 Sunny Point Rd Bldg 44, Southport, NC 28461 | 2018-03-01 |
| 1962882035 | Kimberlee Kreuzer | Physical Therapist | 1517 N Howe St Suite 4, Southport, NC 28461 | 2015-06-04 |
| 1134449291 | Kristos Nektarios Vaughan | Family Medicine | 3009 Medical Plaza Lane, Southport, NC 28461 | 2010-06-10 |
| 1750612974 | Melissa Holden | Nurse Practitioner | 1517 N Howe St Ste 12, Southport, NC 28461 | 2010-01-28 |
| 1437315165 | North Carolina Shoulder and Elbow Surgery and Sports Medicine | Orthopaedic Surgery | 900 North Howe St, Southport, NC 28461 | 2008-08-01 |
| 1124212329 | Edward Frank Babel | Nurse Practitioner | 201 West Boiling Spring Lakes Road, New Hope Clinic, Boiling Spring Lakes, NC 28461 | 2007-08-30 |
| 1952453151 | Robert Wayne Poe | Otolaryngology | 900 N. Howe St, Southport, NC 28461 | 2007-01-17 |
| 1275640898 | Kurt Thomas Scheetz | Dentist | 1301 N Howe Street, Southport, NC 28461 | 2006-08-23 |
| 1396859872 | Brunswick Family Medicine Pa | Family Medicine | 3960 Executive Park Blvd, Unit 600, Southport, NC 28461 | 2006-08-19 |
| Find all providers in zip 28461 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574025 | Nadine Sue Pearish | Nurse Practitioner | 1906 Anna Lauren Dr, Southport, FL 32409-3567 | 2019-12-01 |
| 1184281982 | Jason Glenn Boutwell | Nurse Practitioner | 7120 Caraway Ln, Southport, FL 32409-1605 | 2019-05-28 |
| 1649736653 | Sherrie Gray Cass | Nurse Practitioner | 3960 Executive Park Blvd Ste 600, Southport, NC 28461-8185 | 2019-02-14 |
| 1245552595 | Dora Connelly Loflin | Nurse Practitioner | 4705 Southport Supply Rd Se, Southport, NC 28461-9074 | 2010-02-26 |
| 1861956104 | Kristin Elizabeth Johnston | Nurse Practitioner | 4734 Long Beach Rd Se, Southport, NC 28461-8721 | 2019-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811144 | Alice Bradshaw Callis | Nurse Practitioner | 110 Widgeon Dr, Currituck, NC 27929-9628 | 2020-11-04 |
| 1417558990 | Munira Amirali Ward | Nurse Practitioner | 2617 Valley Haven Dr, Raleigh, NC 27603-3197 | 2020-11-03 |
| 1245830215 | Whitney Rains Taheri | Nurse Practitioner | 3004 Tower Blvd, Durham, NC 27707-2542 | 2020-10-29 |
| 1972103232 | Tauscha Alyse Gerald | Nurse Practitioner | 48 Flora Dr, Benson, NC 27504-8076 | 2020-10-27 |
| 1265031413 | Autumn Grimm | Nurse Practitioner | 511 Lauchwood Dr, Laurinburg, NC 28352-5502 | 2020-10-20 |
| 1619576857 | Candace Allen | Nurse Practitioner | 1215 W Clemmonsville Rd, Winston Salem, NC 27127-4521 | 2020-10-20 |
| 1952900268 | Jennifer Marie Wolfe | Nurse Practitioner | 831 E Morehead St Ste 900, Charlotte, NC 28202-2726 | 2020-10-19 |
| 1720686256 | Sheri Elizabeth Maclean | Nurse Practitioner | 117 Ivy Brook Ln, Chapel Hill, NC 27516-8084 | 2020-10-16 |
| 1326645649 | Christina Mccartney Bulluck | Nurse Practitioner | 105 Nassau Ct, Nashville, NC 27856-1656 | 2020-10-09 |
| 1609473172 | Amy Marie Errichetti | Nurse Practitioner | 1349 Upper Brush Creek Rd, Fairview, NC 28730-9217 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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| 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.