AMANDA LAVENDER (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1033768569

AMANDA LAVENDER (PMHNP) is a healthcare provider. based in Bedford, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 71009545A (IN). The NPI Number for AMANDA LAVENDER (PMHNP) is 1033768569

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA LAVENDER (PMHNP)
NPI
1033768569
Phone
(812) 275-4053
Address
2125 16th St
Enumeration Date
7 September 2019
Last Update Date
9 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8884843258
Graduation Year
2019 (7 years ago)
PAC ID
8729410444
Group Practice PAC ID
9638617913
Professional Enrollment ID
I20191119002032
Address ID
IN462021239IN1701XBLVD400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:6State licenses:2Digital endpointsOther names

8,191 NURSE PRACTITIONER in IN

Provider Addresses for AMANDA LAVENDER (PMHNP)

  • 2125 16th St

    Bedford, IN 474213003

    Phone: (812) 275-4053

    Fax: (812) 275-5494

    Type: Location

  • 2125, 16th Street, Bedford, Lawrence County, Indiana, 47421, United States

    BEDFORD, IN 474213003

    Phone:

    Type: Mailing

  • 727, West 2nd Street, Bloomington, Monroe County, Indiana, 47403, United States

    BLOOMINGTON, IN 474032209

    Phone: (812) 353-3450

    Fax: (812) 353-3451

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2023-10-04 • Largest payer in this snapshot: ABBVIE INC. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$23
View all Open Payments →|Open Payments Risk Radar →

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: 2019-11-19

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
I20191119002032INurse PractitionerINTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 47421)

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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: 9638617913View full group profile
NameSpecialtyState
Pediatric MedicineNC
U R O L O G YIN
Diagnostic Radiology, Interventional RadiologyNY
Nurse PractitionerIN
P A T H O L O G YIN
O T O L A R Y N G O L O G YIN
E N D O C R I N O L O G YIN
Family Practice, Sports MedicineIN
Gastroenterology, Internal MedicineIN
Orthopedic SurgeryMO

Reviews

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Frequently asked questions

What unique ID ties claims to AMANDA LAVENDER (PMHNP)?
NPI 1033768569 is assigned to AMANDA LAVENDER (PMHNP) under the national enumeration system.
Is AMANDA LAVENDER (PMHNP)'s NPI currently valid?
The extract we use shows AMANDA LAVENDER (PMHNP) as active.
What does AMANDA LAVENDER (PMHNP) treat or focus on?
Patients typically see AMANDA LAVENDER (PMHNP) under the specialty Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place AMANDA LAVENDER (PMHNP)?
The snapshot lists Bedford, Indiana for AMANDA LAVENDER (PMHNP); download NPPES for the complete set.
How can I contact AMANDA LAVENDER (PMHNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.