Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Amanda Jean Pettibone-Pond, MD

Individual provider Urology Physician · NPI 1790075596

Dr. Amanda Jean Pettibone-Pond, MD is an Urology in Bloomington, Indiana. Qualified in 2011, 15 years ago. Practices with Outer Banks Professional Services, LLC, a 162-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
15
Licensed in
IN
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone: (812) 676-4500
Fax: (812) 676-4501
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 01076608A (IN)

Record details

NPI number1790075596
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 13, 2011
Last updated in NPPESJuly 6, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Outer Banks Professional Services, Llc — 162 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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