AMANDA SUE WILSON (FNP-BC) – Family Nurse Practitioner, NPI 1356692701

AMANDA SUE WILSON (FNP-BC) is a healthcare provider. based in Harrisonville, Missouri. specializing in Family Nurse Practitioner. They hold the professional credentials FNP-BC. They hold a License No. 2012033367 (MO). The NPI Number for AMANDA SUE WILSON (FNP-BC) is 1356692701

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA SUE WILSON (FNP-BC)
NPI
1356692701
Phone
(816) 380-3582
Address
2820 E ROCK HAVEN RD
Enumeration Date
25 September 2012
Last Update Date
27 April 2015

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
9137800030
Graduation Year
2012 (14 years ago)
PAC ID
4981854056
Group Practice PAC ID
7618881905
Professional Enrollment ID
I20190617002647
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for AMANDA SUE WILSON (FNP-BC)

  • 2820 E ROCK HAVEN RD

    STE. 100

    HARRISONVILLE, MO 647014411

    Phone: (816) 380-3582

    Fax: (816) 380-6964

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 75 Open Payments records for all available years, with a total value of $1,146.

Total Amount is formed as General ($1,146) + Research ($0) + Ownership ($0) = $1,146.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($722).

Total Amount

$1,146

General + Research + Ownership

Payments

75

Total payment records

General Amount

$1,146

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2019-06-17

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
I20190617002647INurse PractitionerKSTBD

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 64701)

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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: 7618881905View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to AMANDA SUE WILSON (FNP-BC)?
NPI 1356692701 is assigned to AMANDA SUE WILSON (FNP-BC) under the national enumeration system.
Is AMANDA SUE WILSON (FNP-BC) active in the national directory?
AMANDA SUE WILSON (FNP-BC)'s public NPI profile is in an active state.
What kind of provider is AMANDA SUE WILSON (FNP-BC)?
The page reflects Family Nurse Practitioner for AMANDA SUE WILSON (FNP-BC). Clinical services aligned with this taxonomy classification.
What location shows for AMANDA SUE WILSON (FNP-BC)?
We surface Harrisonville, Missouri for AMANDA SUE WILSON (FNP-BC) based on available NPPES addresses.
Is AMANDA SUE WILSON (FNP-BC) a real provider?
This page reflects official NPPES data for NPI 1356692701. Always confirm identity and privileges with the practice and licensing boards.

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