Amy Jo Payne, MPAS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001795 Issued in IA

Practice address

1021 Nebraska St
Sioux City, IA 51105-1436

Phone

(712) 252-2477

Fax

(712) 252-5920

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, NE, SD3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apayne637187@direct.ochin.org

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.

• Siouxland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sioux City, IA
  • NPI 1558355305
  Medicare reassignment NPD
• Family Health Care of Siouxland PLC

  • Family Medicine Physician
  • Sioux City, IA
  • NPI 1437170685

  SD

  Medicare reassignment
• Siouxland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • South Sioux City, NE
  • NPI 1912378480
  Medicare reassignment
• Affordable Medical Care LLC

  • Clinic/Center
  • Sioux City, IA
  • NPI 1164702239
  NPD (past)
• Family Health Care of Siouxland LLC

  • Family Medicine Physician
  • Moville, IA
  • NPI 1720278278
  NPD (past)
• Winnebago Indian Health Service

  • General Acute Care Hospital
  • Winnebago, NE
  • NPI 1659392454
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1174640528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HWY 75/77",
            "address_2": "PO BOX HH",
            "city": "WINNEBAGO",
            "state": "NE",
            "postal_code": "68071",
            "telephone_number": "605-232-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 NEBRASKA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051436",
            "telephone_number": "712-252-2477",
            "fax_number": "712-252-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Main St",
            "address_purpose": "LOCATION",
            "city": "North Sioux City",
            "state": "SD",
            "postal_code": "570493113",
            "country_code": "US",
            "telephone_number": "605-232-3412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3410 Futures Dr",
            "address_purpose": "LOCATION",
            "city": "South Sioux City",
            "state": "NE",
            "postal_code": "687763917",
            "country_code": "US",
            "telephone_number": "402-412-7242",
            "fax_number": "712-259-5920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1319",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "001795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick a. Walding DC PC
• Brian Paugh, PA-C
• Kristina Pauley
• Jaclyn Joann Paulson, LMHC
• David Gerhardt Paulsrud, MD
• PCNR, LLC
• PCNR, LLC
• Jon A Peacock, M.D.
• Pech Optical Corp
• Keyona Marie Peck

• Medical Physician Assistant in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Medical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.