Individual provider Active NPI

Amy Haddock, M.D.

  • Obstetrics & Gynecology Physician
  • Tallahassee, FL
National Provider Identifier
1275976862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME130982 Issued in FL
Practice address
1401 Centerville Rd Ste 202
Tallahassee, FL 32308-4638
Phone
(850) 877-7241
Fax
(850) 877-1338
NPI assigned
Apr 12, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME130982 FL Primary

Addresses

Primary practice location

1401 Centerville Rd Ste 202
Tallahassee, FL 32308-4638

Mailing address

1401 Centerville Rd Ste 202
Tallahassee, FL 32308-4638
Phone (850) 877-7241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170830001779 FL Practitioner - Obstetrics/Gynecology 4385948298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Women's Care, P.a.Group PAC ID 0840284923, 20 clinicians

Practice addresses (Care Compare)

1401 Centerville Rd
Suite 202
Tallahassee, FL 32308-4638
Phone (850) 877-7241

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.43 of 100Reported as group
Quality
57.3
Improvement activities
0
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME130982FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Women's Care, P.a. Obstetrics & Gynecology CurrentSince Aug 1, 2017 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1219 Hodges Dr
Tallahassee, FL 32308
Phone (850) 877-5767

1401 Centerville Rd
Ste 202
Tallahassee, FL 32308
Phone (850) 205-0393

Interoperability endpoints

  • Direct secure messaging: ahaddock21686@tallahasseememorial.direct-ci.com
  • Direct secure messaging: amy.haddock.1@28306.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/28306/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275976862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE 202",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-877-7241",
            "fax_number": "850-877-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE 202",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-877-7241",
            "fax_number": "850-877-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "AMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME130982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.