Individual provider Active NPI

Amy Marie Popplewell, NP

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1093418493
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029040 Issued in CA
Practice address
1300 N Dutton Ave
Santa Rosa, CA 95401-7112
Phone
(707) 396-5151
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95272946 CA
Family Nurse Practitioner 363LF0000X 95029040 CA Primary

Addresses

Primary practice location

1300 N Dutton Ave
Santa Rosa, CA 95401-7112

Mailing address

1300 N Dutton Ave
Santa Rosa, CA 95401-7112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20250219003125 CA Practitioner - Nurse Practitioner 9739609843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Rosa Community Health CentersGroup PAC ID 0345130423, 69 clinicians

Practice addresses (Care Compare)

1300 N Dutton Ave
Santa Rosa, CA 95401-7112
Phone (707) 303-3600

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95272946CAMDRegistered Nurse
95029040CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Dec 15, 2024 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Dec 15, 2024 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

3569 Round Barn Cir
Santa Rosa, CA 95403

1300 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 303-3395

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1093418493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112",
            "telephone_number": "707-396-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPLEWELL",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95272946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.