Individual provider Active NPI

Amber Boyd, N.P.

  • Pediatric Nurse Practitioner
  • Carrollton, GA
National Provider Identifier
1407005085
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN149651 Issued in GA
Practice address
107 Wedgewood Dr
Carrollton, GA 30117-4335
Phone
(678) 390-7070
Fax
(678) 390-7071
NPI assigned
Sep 18, 2008
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN149651 GA Primary

Addresses

Primary practice location

107 Wedgewood Dr
Carrollton, GA 30117-4335

Mailing address

222 Gordon St
Bremen, GA 30110-1519
Phone (770) 537-1234

Other identifiers 2

IdentifierTypeStateIssuer
1861915647OtherGAGROUP NPI
RN149651OtherGALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
316 Family Medicine CurrentSince Jun 11, 2023 Accepting new patients
TMC West Georgia Behavioral Health Inc Past Accepting new patients

Locations

222 Gordon St
Bremen, GA 30110
Phone (770) 537-1234

107 Wedgewood Dr
Carrollton, GA 30117
Phone (678) 390-7070

Interoperability endpoints

  • Direct secure messaging: amber.boyd.1@22071.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/22071/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.

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1407005085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 GORDON ST",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301101519",
            "telephone_number": "770-537-1234",
            "fax_number": "770-537-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEDGEWOOD DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174335",
            "telephone_number": "678-390-7070",
            "fax_number": "678-390-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN149651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1861915647",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN149651",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.