AMANDA E BULL – Adult Health Nurse Practitioner, NPI 1396490058

AMANDA E BULL is a healthcare provider. based in Conway, Arkansas. specializing in NURSE PRACTITIONER. They hold a License No. 219121 (AR). The NPI Number for AMANDA E BULL is 1396490058

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA E BULL
NPI
1396490058
Phone
Not provided
Address
2615 GLOHAVEN DR
Enumeration Date
21 February 2022
Last Update Date
30 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5016660249
Graduation Year
2021 (5 years ago)
PAC ID
2062807795
Group Practice PAC ID
5698758803
Professional Enrollment ID
I20220316002669
Address ID
AR722053108LI415XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,410 NURSE PRACTITIONER in AR

Provider Addresses for AMANDA E BULL

  • 2615 GLOHAVEN DR

    CONWAY, AR 720349664

    Phone:

    Type: Mailing

  • 7 SHACKLEFORD WEST BLVD

    LITTLE ROCK, AR 722113886

    Phone: (501) 664-5860

    Type: Location

  • 415 N UNIVERSITY AVE

    LITTLE ROCK, AR 722053108

    Phone: (501) 666-0249

    Fax: (501) 552-5334

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220316002669INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1816$0
View full utilization report →

Insurance plans in this area (ZIP 72034)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698758803View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)AR
-AR
Family Practice, Emergency Medicine, General PracticeGA
Nurse PractitionerAR
Certified Registered Nurse Anesthetist (Crna)AR
Family PracticeAR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Internal MedicineAR
General SurgeryAR

Reviews

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Frequently asked questions

How do payers reference AMANDA E BULL?
For AMANDA E BULL, use NPI 1396490058 as the unique 10-digit identifier.
Is there an active status for AMANDA E BULL?
For scheduling context, AMANDA E BULL is shown as active in the registry.
What area of care is associated with AMANDA E BULL?
AMANDA E BULL's record emphasizes Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is AMANDA E BULL associated with Conway?
Public fields place AMANDA E BULL around Conway, Arkansas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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