Amy Michelle Modlin, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2020-00964 Issued in NC

Practice address

628 E 12TH St
Washington, NC 27889-3409

Phone

(252) 975-4100

NPI assigned

Jun 5, 2017

Last updated

Jan 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040
• Ecu Health Bertie Hospital Hospital, Windsor, NC, CCN 341304

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amodlin301971@direct.vidanthealth.com

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• DX Mso, PLLC

  dba Doctors Express

  • Urgent Care Clinic/Center
  • Chattanooga, TN
  • NPI 1225381148
  Medicare reassignment NPD

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

• East Carolina Health-Bertie

  dba ECU Health Bertie Hospital

  • Critical Access Hospital
  • Windsor, NC
  • NPI 1013999705
  Care Compare affiliation
• Pitt County Memorial Hospital Inc

  dba ECU Health Beaufort Hospital-a campus of ECU Health Medical Center

  • General Acute Care Hospital
  • Washington, NC
  • NPI 1780359687
  Care Compare affiliation
• Pitt County Memorial Hospital, Inc

  dba ECU Health Medical Center

  • General Acute Care Hospital
  • Greenville, NC
  • NPI 1043218944
  Care Compare affiliation

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1144759069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 E 12TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893409",
            "telephone_number": "252-975-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 E 12TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893409",
            "telephone_number": "252-975-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODLIN",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2020-00964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amodlin301971@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Metropolitan Community Health Services, Inc. (Agape Health Services - Carolina Avenue)
• Metropolitan Homecare and Behavioral Services
• Billy R Miller
• Erika Mitchell
• Kaitlyn Mizelle
• Jeffrey Mohr, CST-CSFA
• Monarch
• Monarch
• Brodie Moore, EMT-B
• Latisha Moore, BS

• Family Medicine Physician in Washington, NC
• Providers in Washington, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.