NPIMap

Individual provider Active NPI

Amy Zimmerman Whitlow, DO

  • Family Medicine Physician
  • Forest, VA
National Provider Identifier
1376004853
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102207326 Issued in VA
Practice address
1175 Corporate Park Dr
Forest, VA 24551-2238
Phone
(434) 525-6964
Fax
(434) 525-4035
NPI assigned
Mar 27, 2019
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 0102207326 VA Primary

Addresses

Primary practice location

1175 Corporate Park Dr
Forest, VA 24551-2238

Mailing address

1175 Corporate Park Dr
Forest, VA 24551-2238
Phone (434) 525-6964

Other names 1

  • Dr. Amy Alise Zimmerman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102001940 VA Practitioner - Family Practice 4688909641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

1175 Corporate Park Dr
Forest, VA 24551-2238
Phone (434) 525-6964

131 Jones St
Appomattox, VA 24522-9830
Phone (434) 352-8235

2215 Landover PL
Lynchburg, VA 24501-2115
Phone (434) 947-3944

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102207326VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Sep 8, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Sep 8, 2022 Accepting new patients
Medical Associates of Central Virginia, Inc. Past Accepting new patients

Locations

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

1175 Corporate Park Dr
Forest, VA 24551
Phone (434) 525-6964

2019 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 845-7035

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: amy.whitlow.1@8042.direct.athenahealth.com

Organizations & group practices 3

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 10

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1376004853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 CORPORATE PARK DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512238",
            "telephone_number": "434-525-6964",
            "fax_number": "434-525-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CORPORATE PARK DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512238",
            "telephone_number": "434-525-6964",
            "fax_number": "434-525-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOW",
        "first_name": "AMY",
        "middle_name": "ZIMMERMAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ZIMMERMAN",
            "middle_name": "ALISE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.