Amy Lee Hostetter, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

69224 Issued in GA

Practice address

115 Vickery St Ste 100
Roswell, GA 30075-4977

Phone

(678) 883-6096

Fax

(678) 373-3330

NPI assigned

Apr 30, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Jul 31, 2018 through Jul 31, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Psychological Source, Inc.

  • Clinical Social Worker
  • Marietta, GA
  • NPI 1740421163
  NPD (past)

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1053555359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 VICKERY ST STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754977",
            "telephone_number": "678-883-6096",
            "fax_number": "678-373-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 VICKERY ST STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754977",
            "telephone_number": "678-883-6096",
            "fax_number": "678-373-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETTER",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "69224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Hopkins, MA, LPC, RPT
• Laura Thompson Hopkins, PHARMACIST
• Nicole Hopkins, LPC
• Alantra Hopper, RBT
• Katharine Elizabeth Horne, BS, RBT
• Terri Rene Houff, LMFT
• Hovey Chiropractic Clinic PC
• James S Hovey, D.C.
• Brian Keith Howard, M.D.
• John Roger Howard, LMT

• Psychiatry Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.