Amanda Lynn Whitehead, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Columbia, South Carolina. Her current practice location is
115 Blarney Dr, Columbia, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 254-5171.
Amanda Lynn Whitehead is licensed to practice in South Carolina (license number APN.29187) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1194565515.
Physician's Profile
| Full Name | Amanda Lynn Whitehead |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 115 Blarney Dr, Columbia, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1194565515
- Provider Enumeration Date: 05/31/2024
- Last Update Date: 08/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 9537691654
- Enrollment ID: I20241015000637
Medical Identifiers
Medical identifiers for Amanda Lynn Whitehead such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1194565515 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QA0000X | Family Medicine - Adolescent Medicine | APN.29187 (South Carolina) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | APN.29187 (South Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APN.29187 (South Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Lynn Whitehead allows following entities to bill medicare on her behalf.
| Entity Name | Providence Family Practice Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528066115
PECOS PAC ID: 4284658865
Enrollment ID: O20060123000299 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Lynn Whitehead is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amanda Lynn Whitehead, NP
125 Living Waters Blvd,
Lexington, SC 29073-8422
Ph: (484) 714-7007 | Amanda Lynn Whitehead, NP
115 Blarney Dr,
Columbia, SC 29223-6291
Ph: (803) 254-5171 |
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