Amanda Soudom, APRN is a medicare enrolled "Nurse Practitioner - Family" in Battletown, Kentucky. Her current practice location is
1600 Willetts Bottom Rd, Battletown, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(502) 475-1038.
Amanda Soudom is licensed to practice in Kentucky (license number 4015068) 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 1467223685.
Provider's Profile
Full Name | Amanda Soudom |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 1600 Willetts Bottom Rd, Battletown, Kentucky |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1467223685
- Provider Enumeration Date: 01/16/2024
- Last Update Date: 01/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860831930
- Enrollment ID: I20240423000089
Medical Identifiers
Medical identifiers for Amanda Soudom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467223685 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 4015068 (Kentucky) | 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 Soudom allows following entities to bill medicare on her behalf.
Entity Name | Baptist Health Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1740586213 PECOS PAC ID: 5597867184 Enrollment ID: O20070228000503 |
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Entity Name | Signify Health Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1689158487 PECOS PAC ID: 3274895263 Enrollment ID: O20210209002652 |
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Entity Name | Bhg Lviii, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417696543 PECOS PAC ID: 4284002783 Enrollment ID: O20221114002932 |
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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 Soudom 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 |
Amanda Soudom, APRN 1600 Willetts Bottom Rd, Battletown, KY 40104-7316 Ph: (502) 475-1038 | Amanda Soudom, APRN 1600 Willetts Bottom Rd, Battletown, KY 40104-7316 Ph: (502) 475-1038 |
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