Individual provider Active NPI

Amanda Gohlke, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • North Chesterfield, VA
National Provider Identifier
1275896102
Registry record updated Jun 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
D0085010 Issued in MD
Practice address
1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730
Phone
(804) 483-5155
NPI assigned
Jun 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MT201300 PA
Student in an Organized Health Care Education/Training Program 390200000X VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X D0085010 MD Primary

Addresses

Primary practice location

1401 Johnston Willis Dr
North Chesterfield, VA 23235-4730

Mailing address

PO Box 980662
Path: Pathology Ap/CP
Richmond, VA 23298-0662
Phone (804) 628-1690

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20191015001626 VA Practitioner - Pathology 2668607896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Eastern Virginia Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forward Pathology Solutions LLCGroup PAC ID 2668703109, 25 clinicians

Practice addresses (Care Compare)

1602 Skipwith Rd
Richmond, VA 23229-5205
Phone (804) 289-4852

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT201300PAMDObstetrics & Gynecology Physician
D0085010MDMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Pathology Solutions LLC Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 2019 Accepting new patients

Locations

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

2621 Grove Ave
Richmond, VA 23220
Phone (804) 252-5433

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.

Hospital & facility affiliations 3

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685750400000",
    "number": "1275896102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980662",
            "address_2": "PATH: PATHOLOGY AP/CP",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980662",
            "telephone_number": "804-628-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JOHNSTON WILLIS DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-483-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHLKE",
        "first_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2023-06-03",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT201300",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MD",
            "license": "D0085010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.