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Amanda Dawn Self

Physician • Tennessee Ridge, TN

Active NPI 1245815109 Individual Practitioner Female Practitioner
Practice location in NPPES

1330 N Main St
Tennessee Ridge, TN 371784003

Call 8882914357 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1330 N Main St

Tennessee Ridge, TN 371784003

Telephone 8882914357
Organization at the Same NPPES Address or Phone
Centerstone Military Services, Inc. Facility NPI 1043024904

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-02-18
Intermediate Care Facility, Mental Illness Primary Specialty

NUCC Taxonomy Code: 310500000X

A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Tennessee Department of Health License Verification.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Lakesha Brisbane

Nurse Practitioner - Psychiatric/Mental Health

NPI 1790318848
Natalie Durr

Nurse Practitioner - Psychiatric/Mental Health

NPI 1528361490
Sarah Hagood , NURSE PRACTITIONER

Nurse Practitioner - Psychiatric/Mental Health

NPI 1730814815

NURSEPRACTITIONER

Catherine Vest , LCSW

Social Worker - Clinical

NPI 1891354338

Licensed Clinical Social Worker

Evana Yates , NP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1235308305

Nurse Practitioner

Career & Practice History

NPI enumerated March 12, 2021.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from April 2021 to November 2026.

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NPI Administrative Meta

NPI Number: 1245815109
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 12, 2021
Last Update: March 12, 2021
Sole Proprietor: Yes

Mailing Address

220 Mockingbird St

Erin, TN 370616098

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.