Individual provider Active NPI

Ami L Goldstein, CNM, FNP

  • Family Nurse Practitioner
  • Chapel Hill, NC
National Provider Identifier
1093811556
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201687 Issued in NC
Practice address
590 Manning Dr
Chapel Hill, NC 27599-6119
Phone
(919) 966-4996
Fax
(919) 843-5515
NPI assigned
Sep 15, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201687 NC Primary
Advanced Practice Midwife 367A00000X 236 NC
Family Medicine Physician 207Q00000X 147206 NC

Addresses

Primary practice location

590 Manning Dr
Chapel Hill, NC 27599-6119

Mailing address

143 W Franklin St
Chapel Hill, NC 27516-2539
Phone (919) 966-4996

Other identifiers 1

IdentifierTypeStateIssuer
7002053MedicaidNC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address agoldstein20502@direct.UNC.nchie.net Direct
Direct Messaging Address agoldstein20502@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090507000669 NC Practitioner - Nurse Practitioner 9032147913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220

3708 Mayfair St
Durham, NC 27707-6223

5704 Fayetteville Rd
Durham, NC 27713-9089
Phone (919) 228-2427

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147206NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center Past Accepting new patients
Park Ophthalmology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: agoldstein20502@direct.unc.nchie.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1093811556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 W FRANKLIN ST",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275162539",
            "telephone_number": "919-966-4996",
            "fax_number": "919-843-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275996119",
            "telephone_number": "919-966-4996",
            "fax_number": "919-843-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "AMI",
        "middle_name": "L",
        "credential": "CNM, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201687",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "236",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "147206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002053",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agoldstein20502@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "590 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275996119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agoldstein20502@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "3708 Mayfair St Ste 100",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277076223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.