Terri Hunt Amos, ARNP

Individual provider Active NPI Nurse Practitioner · Bowling Green, KY

NPI 1104887314 · NPPES record last updated Apr 24, 2008

Key facts

NPI
1104887314
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
4731P (KY)
Practice address
1320 Andrea St
Bowling Green, KY 42104
Phone
(270) 746-5455
Fax
(270) 746-5688
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tim Long MD PSC (3 clinicians)

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital · Bowling Green, KY · CCN 180013
  • Tristar Greenview Regional Hospital Hospital · Bowling Green, KY · CCN 180124

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060106000022 KY Practitioner - Nurse Practitioner 0042233942 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4731PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tim Long M.D., PSC Current
since Sep 20, 2005
Accepting new patients
NP Group of Tim Long MD PSC Past
since 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/Endpoint/EBCCBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/EBCCBA

Specialties & licenses

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

Addresses

Primary practice location

1320 Andrea St
Bowling Green, KY 42104

Mailing address

103 Carroll Rd
Morgantown, KY 42261

Other identifiers

IdentifierTypeStateIssuer
78018199MedicaidKY
000000489598OtherKYANTHEM BC/BS
7100028630OtherKYMEDICAID GROUP

Other providers in Bowling Green, KY

All providers in Bowling Green, KY · Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.