Amy Jo Couch, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5018243 Issued in NC

Practice address

1255 Creekshire Way Ste 270
Winston Salem, NC 27103-3061

Phone

(833) 701-3111

NPI assigned

Jun 13, 2023

Last updated

Jun 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Certus Psychiatry and Integrated Care PLLCGroup PAC ID 0244506756, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Certus Psychiatry and Integrated Care PLLC

  dba Cpic

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1609317569
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1073297727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 SHOALEY BRANCH CHURCH RD",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286218486",
            "telephone_number": "336-469-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY STE 270",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033061",
            "telephone_number": "833-701-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCH",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5018243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation (Costco Optical #361)
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• Karen Hoke Coston
• Kristie Cothren, MA, CCC-SLP
• Deanna Marie Cotsalas, M.D., M.H.S.
• Catherine Terese Coughlin, PA-C
• Sarah Coulter, MS, RD, LD
• Dawn Marie Coulthurst Mason, PMHNP
• William Chirstopher Council Jr.
• Chase Countryman

• Psychiatric/Mental Health Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.