Active NPI
Amy W Anzilotti, MD
- Pediatrics Physician
- Wilmington, DE
National Provider Identifier
1194927053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C10007447
- Practice address
- 910 Foulk Road
Suite 101
Wilmington, DE 19803-3157 - Phone
- (302) 655-3242
- Fax
- (302) 655-5392
- NPI assigned
- Jun 4, 2007
- Last updated
- Oct 22, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C10007447 | DE | Primary |
| General Practice Physician | 208D00000X | C10007447 | DE |
Addresses
Primary practice location
910 Foulk Road
Suite 101
Wilmington, DE 19803-3157
Mailing address
PO Box 191
Rockland, DE 19723-0191
Phone (302) 651-6212
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102040993 | Medicaid | PA | |
| 0136247 | Medicaid | NJ | |
| 413092800 | Medicaid | MD |
Other names 1
- Amy Wagner
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C10007447 | DE | MD | General Practice Physician |
Interoperability endpoints
- aanzilotti6541@direct.nemours.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319241600000",
"number": "1194927053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197230191",
"telephone_number": "302-651-6212",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 FOULK ROAD",
"address_2": "SUITE 101",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198033157",
"telephone_number": "302-655-3242",
"fax_number": "302-655-5392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANZILOTTI",
"first_name": "AMY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2011-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C10007447",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "DE",
"license": "C10007447",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102040993",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0136247",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "413092800",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "WAGNER",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.