Individual provider Active NPI

Amy Hamilton, FNP-C

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1083157788
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22064 Issued in TN
Practice address
119 Boone Ridge Dr
Ste 201
Johnson City, TN 37615-8000
Phone
(423) 282-1480
Fax
(423) 928-1353
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22064 TN Primary

Addresses

Primary practice location

119 Boone Ridge Dr
Ste 201
Johnson City, TN 37615-8000

Mailing address

119 Boone Ridge Dr
Ste 201
Johnson City, TN 37615-8000
Phone (423) 282-1480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170131001393 TN Practitioner - Nurse Practitioner 5496037236 Reassigns benefits to 1 organization
I20211109002228 GA Practitioner - Nurse Practitioner 5496037236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Apr 2, 2022 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Oct 21, 2024 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Oct 21, 2024 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Apr 2, 2022 Accepting new patients
Southeastern Physician Services PC CurrentSince Jan 5, 2017 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

115 Woodlawn Dr
Johnson City, TN 37604
Phone (423) 943-0956

140 Technology Ln
Johnson City, TN 37604
Phone (423) 434-2016

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1083157788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376158000",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376158000",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "AMY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.