Active NPI
Jacqueline Amis, MD
- Obstetrics & Gynecology Physician
- Tampa, FL
National Provider Identifier
1124384599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME128045
- Practice address
- 2 Tampa General Cir
STC 6TH Floor
Tampa, FL 33606-3603 - Phone
- (813) 259-8500
- Fax
- (813) 259-8623
- NPI assigned
- Apr 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME128045 | FL | Primary |
Addresses
Primary practice location
2 Tampa General Cir
STC 6TH Floor
Tampa, FL 33606-3603
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BZCWI | Other | FL | BLUE CROSS BLUE SHIELD FLORIDA |
| 017899900 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jamis114229@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Service Association Inc | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
- Neurological Surgery Physician
- Tampa, FL
- NPI 1740227966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1124384599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001",
"telephone_number": "813-974-2201",
"fax_number": "813-974-2812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 TAMPA GENERAL CIR",
"address_2": "STC 6TH FLOOR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063603",
"telephone_number": "813-259-8500",
"fax_number": "813-259-8623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIS",
"first_name": "JACQUELINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-10",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME128045",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD FLORIDA",
"identifier": "BZCWI",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017899900",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jamis114229@direct.tgh.org",
"affiliation": "N",
"address_1": "2 Tampa General Cir",
"address_2": "STC 6th Floor",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336063603",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.