Individual provider Active NPI

Amy Lynn Richardson, NP-C

  • Family Nurse Practitioner
  • Winchester, TN
National Provider Identifier
1205221884
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19889 Issued in TN
Practice address
615 River Watch Way
Winchester, TN 37398-3506
Phone
(931) 998-2915
Fax
(931) 998-2915
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000019889 TN
Family Nurse Practitioner 363LF0000X 19889 TN Primary

Addresses

Primary practice location

615 River Watch Way
Winchester, TN 37398-3506

Mailing address

615 River Watch Way
Winchester, TN 37398-3506
Phone (931) 998-2915

Other practice location 1

1218 Trotwood Ave
Columbia, TN 38401
Phone (931) 381-1111 ext. 1575

Other practice location 2

1218 Trotwood Ave
Columbia, TN 38401
Phone (931) 381-1111 ext. 1575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150701001832 TN Practitioner - Nurse Practitioner 3779895834 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

906 Dinah Shore Blvd
Suite 102
Winchester, TN 37398-1102
Phone (931) 998-2915

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19889TNMDFamily Nurse Practitioner
APN0000019889TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Med, PLLC Family CurrentSince Mar 1, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 23, 2015 Accepting new patients
Southeastern Emergency Services P C CurrentSince Jun 1, 2015 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 23, 2015 Accepting new patients

Locations

1900 N Winston Rd
Ste 300
Knoxville, TN 37919
Phone (865) 271-6000

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

906 Dinah Shore Blvd
Ste 102
Winchester, TN 37398
Phone (931) 998-2915

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIFDDD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1205221884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 RIVER WATCH WAY",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373983506",
            "telephone_number": "931-998-2915",
            "fax_number": "319-982-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 RIVER WATCH WAY",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373983506",
            "telephone_number": "931-998-2915",
            "fax_number": "931-998-2915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1218 Trotwood Ave",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "38401",
            "country_code": "US",
            "telephone_number": "931-381-1111 x1575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1218 Trotwood Ave",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "38401",
            "country_code": "US",
            "telephone_number": "931-381-1111 x1575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000019889",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

Verify at the official NPI Registry.