Individual provider Active NPI

Amy Marie Volk, PA-C

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1356980247
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009807 Issued in MI
Practice address
19725 W 12 Mile Rd
Southfield, MI 48076-2584
Phone
(248) 770-5205
NPI assigned
Dec 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009807 MI Primary

Addresses

Primary practice location

19725 W 12 Mile Rd
Southfield, MI 48076-2584

Mailing address

7931 Stout Ave
Grosse Ile, MI 48138-1392
Phone (734) 558-8121

Other practice location 1

1768 Ford Ave
Wyandotte, MI 48192-2306
Phone (734) 299-0712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200211000673 MI Practitioner - Physician Assistant 9638505688 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Urgent Care PLLCGroup PAC ID 9234538901, 5 clinicians
Wyandotte Urgent Care ClinicGroup PAC ID 4183996150, 17 clinicians
Southshore Urgent Care PLLCGroup PAC ID 5698009777, 14 clinicians

Practice addresses (Care Compare)

1407 E Michigan Ave
Jackson, MI 49202-3517
Phone (517) 888-6348

1768 Ford Ave
Wyandotte, MI 48192-2306
Phone (313) 377-5758

20789 Gibraltar Rd
Brownstown TWP, MI 48183-5087
Phone (734) 444-2961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Urgent Care PLLC CurrentSince Jul 1, 2026 Accepting new patients

Locations

20789 Gibraltar Rd
Brownstown Twp, MI 48183
Phone (734) 444-2961

1407 E Michigan Ave
Jackson, MI 49202
Phone (517) 784-1142

1768 Ford Ave
Wyandotte, MI 48192
Phone (313) 377-5758

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1577232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1356980247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7931 STOUT AVE",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481381392",
            "telephone_number": "734-558-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19725 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762584",
            "telephone_number": "248-770-5205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1768 Ford Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481922306",
            "country_code": "US",
            "telephone_number": "734-299-0712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLK",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-25",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.