Amy M Dimitriades, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R859046 Issued in MS

Practice address

4540 W Railroad St
Gulfport, MS 39501-2480

Phone

(228) 867-6062

Fax

(228) 867-2598

NPI assigned

Jun 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kih Advanced Kare, LLCGroup PAC ID 8325457492, 4 clinicians

Care Doc LLCGroup PAC ID 7719223957, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adimitriades@direct.mhg.com

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.

• Care Doc LLC

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1225505993
  Medicare reassignment Care Compare group NPD
• Kih Advanced Kare, LLC

  • Nurse Practitioner
  • Gulfport, MS
  • NPI 1861082901
  Medicare reassignment Care Compare group
• Singing River Gulfport

  • Multi-Specialty Clinic/Center
  • Gulfport, MS
  • NPI 1861010159
  Medicare reassignment NPD
• Singing River Health System

  • Multi-Specialty Clinic/Center
  • Gautier, MS
  • NPI 1083893937
  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment
• Caredoc LLC

  • Physical Medicine & Rehabilitation Physician
  • Gulfport, MS
  • NPI 1306583505
  NPD
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  • Internal Medicine Physician
  • Bay St Louis, MS
  • NPI 1518394089
  NPD
• Singing River Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1487327193
  NPD
• Singing River Health System

  • Internal Medicine Physician
  • Pascagoula, MS
  • NPI 1134283419
  NPD

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1396065694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-865-1330",
            "fax_number": "228-865-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 W RAILROAD ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012480",
            "telephone_number": "228-867-6062",
            "fax_number": "228-867-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITRIADES",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R859046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Dickerson, PCCSS
• Dorothy Dickson-Rishel, PHD
• Tiffany McLain Dillard
• Jenesia Arielle Dillow Ordonia
• Leah Ashley Guerrero Dimalanta, OTR/L
• Dimitrios J Dimitriades, M.D.
• Discovering You Supervised Living Homes
• Distinct Home Health Care Inc
• Peggy Ditta, C.R.N.A.
• Brian R Dix, D.O.

• Family Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.