Individual provider Active NPI

Terri Hunt Amos, ARNP

  • Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1104887314
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4731P Issued in KY
Practice address
1320 Andrea St
Bowling Green, KY 42104
Phone
(270) 746-5455
Fax
(270) 746-5688
NPI assigned
Mar 29, 2006
Last updated
Apr 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4731P KY Primary

Addresses

Primary practice location

1320 Andrea St
Bowling Green, KY 42104

Mailing address

103 Carroll Rd
Morgantown, KY 42261

Other identifiers 3

IdentifierTypeStateIssuer
7100028630OtherKYMEDICAID GROUP
000000489598OtherKYANTHEM BC/BS
78018199MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20060106000022 KY Practitioner - Nurse Practitioner 0042233942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tim Long MD PSCGroup PAC ID 7810968104, 3 clinicians

Practice addresses (Care Compare)

1320 Andrea St
Bowling Green, KY 42104-3334
Phone (270) 746-5455

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4731PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tim Long M.D., PSC CurrentSince Sep 20, 2005 Accepting new patients
NP Group of Tim Long MD PSC PastSince Sep 20, 2005 Accepting new patients

Locations

1320 Andrea St
Bowling Green, KY 42104
Phone (270) 746-5455

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBCCBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EBCCBA/Endpoint/EBCCBA

Organizations & group practices 2

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 2

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1104887314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CARROLL RD",
            "city": "MORGANTOWN",
            "state": "KY",
            "postal_code": "42261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 ANDREA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42104",
            "telephone_number": "270-746-5455",
            "fax_number": "270-746-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOS",
        "first_name": "TERRI",
        "middle_name": "HUNT",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4731P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "7100028630",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000489598",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78018199",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.