Amanda Dawn Self
NPI 1245815109ActiveIndividual· Intermediate Care Facility, Mental Illness· Tennessee Ridge, TN
Intermediate Care Facility, Mental Illness in Tennessee Ridge, Tennessee, with an NPI issued in March 2021.
Overview
| NPI | 1245815109 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Mar 12, 2021 |
| Last updated in NPPES | Mar 12, 2021 |
| Certified by provider | Feb 18, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Mental Illness Primary | 310500000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|