Individual provider Active NPI

Amy P King, NP

  • Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1346442472
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024167201 Issued in VA
Practice address
2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153
Phone
(757) 539-3911
Fax
(757) 925-0615
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 0024167201 VA
Nurse Practitioner 363L00000X 0024167201 VA Primary

Addresses

Primary practice location

2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153

Mailing address

2790 Godwin Blvd Ste 360
Suffolk, VA 23434-8153
Phone (757) 539-3911

Other identifiers 3

IdentifierTypeStateIssuer
1821133174MedicaidVA
0024167201OtherVALICENSE
790259HMedicaidNC

Other names 1

  • Amy Pearce Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130801000065 VA Practitioner - Nurse Practitioner 9830330968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2790 Godwin Blvd
Suite 360
Suffolk, VA 23434-8151

2790 Godwin Blvd
Suite360
Suffolk, VA 23434-8153

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.45 of 100Reported as group
Quality
76.15
Promoting interoperability
100
Improvement activities
40
Cost
75.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024167201VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Womens Care PLC CurrentSince Jun 3, 2013 Accepting new patients
Mid-Atlantic Womens Care PLC Past Accepting new patients

Locations

844 Kempsville Rd
Ste 208
Norfolk, VA 23502
Phone (757) 461-3890

2050 Hillpoint Blvd N
Suffolk, VA 23434
Phone (757) 290-6190

1510 Breezeport Way
Ste 600
Suffolk, VA 23435
Phone (757) 539-3911

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 and National Provider Directory roles.

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1346442472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 360",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348153",
            "telephone_number": "757-539-3911",
            "fax_number": "757-925-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 360",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348153",
            "telephone_number": "757-539-3911",
            "fax_number": "757-925-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "AMY",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024167201",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024167201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821133174",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0024167201",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790259H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "PEARCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.