AMANDA JUNE BASHAM FNP -BC
NPI 1780326454
Nurse Practitioner in Granite City, IL

Q: What is Amanda Basham's NPI number?

The NPI number for Amanda Basham is 1780326454. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Q: What is Amanda Basham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Basham was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2022PECOS EnrolledAccepts Medicare Assignment

3986 MARYVILLE RD, GRANITE CITY, IL 62040(618) 797-0618 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Amanda June Basham Fnp -bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA JUNE BASHAM FNP -BC (NPI 1780326454) is an individual nurse practitioner in Granite City, Illinois, licensed in Illinois (209025025) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, is affiliated with Gateway Regional Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1780326454

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameAMANDA JUNE BASHAMCredential: FNP -BC

Location Address3986 MARYVILLE RDGranite City, IL 62040-4191

Mailing Address3986 Maryville RdGranite City, IL 62040-4191 · (618) 797-0618

Phone(618) 797-0618

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 12, 2022

NPPES CertifiedApril 11, 2022

✔ NPI 1780326454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209025025

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3986 MARYVILLE RD, Granite City, IL 62040

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Other Identifiers 1

Other1811087604Npi

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda June Basham Fnp -bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698139558

PECOS Enrollment IDI20230911001991

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Gateway Regional Medical Center

Acute Care Hospitals · Granite City, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140125

Location2100 Madison AvenueGranite City, IL 62040 · Madison County

Emergency services

Anderson Hospital

Acute Care Hospitals · Maryville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140289

Location6800 State Route 162Maryville, IL 62062 · Madison County

Emergency services Birthing friendly

St Lukes Hospital

Acute Care Hospitals · Chesterfield, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260179

Location232 S Woods Mill RdChesterfield, MO 63017 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62040 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROSS TYLER DC

Chiropractor