AMANDA NICOLE SHORTRIDGE (FNP-C) – Family Nurse Practitioner, NPI 1659118693

AMANDA NICOLE SHORTRIDGE (FNP-C) is a healthcare provider. based in Bristol, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 0024190694 (VA). The NPI Number for AMANDA NICOLE SHORTRIDGE (FNP-C) is 1659118693

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA NICOLE SHORTRIDGE (FNP-C)
NPI
1659118693
Phone
(423) 963-8832
Address
10039 REEDY CREEK RD
Enumeration Date
9 July 2024
Last Update Date
9 July 2024

Doctor Profile

Medical School Name
EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Secondary Phone
2764513044
Graduation Year
2024 (2 years ago)
PAC ID
6002348836
Group Practice PAC ID
7810121274
Professional Enrollment ID
I20241017001073
Address ID
VA242103408AB418XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

8,307 NURSE PRACTITIONER in VA

Provider Addresses for AMANDA NICOLE SHORTRIDGE (FNP-C)

  • 10039 REEDY CREEK RD

    BRISTOL, VA 242022921

    Phone: (423) 963-8832

    Fax: (276) 206-2228

    Type: Mailing

  • 418 E MAIN ST

    ABINGDON, VA 242103408

    Phone: (423) 963-8832

    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 $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2024-07-08 • Largest payer in this snapshot: Optinose US, Inc. ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-08

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Optinose US, Inc.$25
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: 2024-10-17

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
I20241017001073INurse PractitionerVATBD

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 24202)

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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: 7810121274View full group profile
NameSpecialtyState
Physician AssistantVA
O T O L A R Y N G O L O G YVA
Physician AssistantVA
Nurse PractitionerVA
-VA

Reviews

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Frequently asked questions

What is the 10-digit NPI for AMANDA NICOLE SHORTRIDGE (FNP-C)?
AMANDA NICOLE SHORTRIDGE (FNP-C) — NPI 1659118693 — is the standard way to identify this listing.
Is AMANDA NICOLE SHORTRIDGE (FNP-C) listed as active for patients and plans?
The listing shows AMANDA NICOLE SHORTRIDGE (FNP-C) as active in the NPI system.
What taxonomy line describes AMANDA NICOLE SHORTRIDGE (FNP-C)?
For research purposes, treat AMANDA NICOLE SHORTRIDGE (FNP-C) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect AMANDA NICOLE SHORTRIDGE (FNP-C) on a map?
Expect Bristol, Virginia as a primary anchor for AMANDA NICOLE SHORTRIDGE (FNP-C) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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