Individual provider Active NPI

Amy M Pendleton, ARNP

  • Women's Health Nurse Practitioner
  • Irvine, KY
National Provider Identifier
1043496813
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4276P Issued in KY
Practice address
365 River Drive
Irvine, KY 40336-0115
Phone
(606) 723-5181
Fax
(606) 723-5254
NPI assigned
Jan 11, 2008
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4276P KY Primary

Addresses

Primary practice location

365 River Drive
Irvine, KY 40336-0115

Mailing address

PO Box 115
Irvine, KY 40336-0115
Phone (606) 723-5181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4276PKYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Estill County Health Department Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1043496813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403360115",
            "telephone_number": "606-723-5181",
            "fax_number": "606-723-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 RIVER DRIVE",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403360115",
            "telephone_number": "606-723-5181",
            "fax_number": "606-723-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "4276P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.