AMANDA DECOURSEY
AMANDA KROMER · Nurse Practitioner (Family)

Address: 50 Post Office Rd Ste 303, Waldorf, MD 20602-3704

AMANDA DECOURSEY (NPI# 1417552613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417552613
Entity Type Individual
Full Name AMANDA DECOURSEY
Other Name AMANDA KROMER (Former Name)
Gender Female
Credential NP
Practice Address 50 Post Office Rd Ste 303
Waldorf
MD 20602-3704
Practice Telephone 2403492448
Mailing Address 46118 Edgemore Way
Great Mills
MD 20634-3099
Mailing Telephone 8587332178
Certification Date 2020-12-03
Enumeration Date 2020-12-03
Last Update Date 2020-12-03
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 363LF0000X Nurse Practitioner
Specialization: Family
R212789 MD Physician Assistants & Advanced Practice Nursing Providers

Associated Endpoints

Endpoint Type Endpoint Affiliation Affiliation Address Use Content
Other URL 2403492243 (fax) 50 Post Office Rd Ste 303, Waldorf, MD 206023704

Physician Overview

PECOS Associate Control (PAC) ID 3274949565
by Medicare Provider Enrollment and Chain/Ownership System (PECOS)
Professional Enrollment ID I20210311001032
Last Name DECOURSEY
First Name AMANDA
Organization Legal Name BAYSIDE PRIMARY CARE LLC
Location 489 Main St, Suite 102, Prince Frederick, MD 20678-3188
Phone Number 4104145633
Graduation Year 2020
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 6800806159
Number of Group Practice Members 3

Office Location

Street Address 50 POST OFFICE RD STE 303
City WALDORF
State MD
Zip Code 20602-3704

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891734299 Orpro Inc · Orpro Prosthetics & Orthotics Prosthetic/Orthotic Supplier 50 Post Office Road, Suite 301, Waldorf, MD 20602-3704 2006-06-04
1801120175 Hanger Prosthetics & Orthotics Inc · Hanger Clinic Durable Medical Equipment & Medical Supplies 50 Post Office Rd Ste 301, Waldorf, MD 20602-3704 2009-09-19
1033718762 White Plains Primary Care Nurse Practitioner - Psych/Mental Health 50 Post Office Rd Ste 304, Waldorf, MD 20602-3704 2020-10-23

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1346673266 Djuana Anita Williams Lactation Consultant, Non-RN 2903 Holburn Ct, Waldorf, MD 20602 2013-08-14
1023385457 Kristen Elise Lohr Physician Assistant 12090 Old Line Centre, Waldorf, MD 20602 2011-11-30
1811404296 Loni Berbaum Speech-Language Pathologist 4817 Elmley Pl Apt 315, Waldorf, MD 20602 2018-01-06
1588097323 Otis Cleveland Jr. Pharmacist 10 King Street, Waldorf, MD 20602 2013-08-15
1831788603 Bukola Morufat Zubair Nurse Practitioner - Psych/Mental Health 4992 Oyster Reef Place, Waldorf, MD 20602 2021-01-15
1467945030 Donna Marie Conley-Shaw Behavior Technician 16 Pagnell Cir, Waldorf, MD 20602 2018-06-08
1609184977 Evelyn May Chou Dentist 3500 Old Washington Road, Suite 301, Waldorf, MD 20602 2010-09-20
1235445966 Deirdre Cullum Counselor - Professional 3261 Old Washington Rd Ste 2020, Waldorf, MD 20602 2010-08-18
1033348032 Besi Long Tong Dentist - Orthodontics and Dentofacial Orthopedics 3500 Old Washington Rd Ste 301, Waldorf, MD 20602 2009-07-11
1891224853 Linda E Smith Social Worker - Clinical 605 Pst Office Road, #301, Waldorf, MD 20602 2017-06-05
Find all in zip 20602

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699346379 Vasilina Johnson Nurse Practitioner - Family 3070 Crain Hwy Ste 101, Waldorf, MD 20601-2831 2021-07-05
1538734579 Irene Bwete-Mugyenzi Nurse Practitioner - Family 11306 Wildmeadows St, Waldorf, MD 20601-2684 2021-05-21
1457963001 Carrie Ann Catalan Nurse Practitioner - Family 1036 Saint Nicholas Dr, Waldorf, MD 20603-4757 2020-08-17
1285021444 Margaret Owusu Nurse Practitioner - Family 11315 Pembrooke Square, Waldorf, MD 20735 2015-04-24
1619390325 Tara Wood Nurse Practitioner - Family 3070crain Highway, Waldorf, MD 20603 2014-01-31
1548508278 Hilda Mungen Chi Nurse Practitioner - Family 5475 Saint Rita Dr, Waldorf, MD 20602-3277 2013-01-31
1275893794 Nji Julius Fru Nurse Practitioner - Family 2670 Crain Hwy Ste 408, Waldorf, MD 20601-2818 2012-05-17
1194323758 Leticia G Bustamante Sanchez Nurse Practitioner - Family 2255 Crain Hwy Ste 107, Waldorf, MD 20601-3186 2020-10-15
1508423351 Mary Dayo Adebowale Nurse Practitioner - Family 3500 Old Washington Rd Ste 101, Waldorf, MD 20602-3205 2019-05-28
1760952410 Angela S Barnes Nurse Practitioner - Family 3460 Old Washington Rd Ste 300, Waldorf, MD 20602-3245 2018-11-26
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Competitor

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City WALDORF
Zip Code 20602

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Dataset Information

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.