Jacquelynn Marie Amick

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

101 Executive Center Dr
Ste. 120
Columbia, SC 29210-8411

Phone

(843) 855-0597

Fax

(803) 896-8279

NPI assigned

Mar 4, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• SC School for the Deaf and the Blind

  • Case Management Agency
  • Columbia, SC
  • NPI 1104165042
  NPD (past)

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1407197312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EXECUTIVE CENTER DR",
            "address_2": "STE. 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108411",
            "telephone_number": "843-855-0597",
            "fax_number": "803-896-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EXECUTIVE CENTER DR",
            "address_2": "STE. 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108411",
            "telephone_number": "843-855-0597",
            "fax_number": "803-896-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMICK",
        "first_name": "JACQUELYNN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• American Health Imaging of South Carolina, LLC
• American Hearing Service
• American Pride Medical Transportation, LLC
• Amerigroup Community Care of South Caroli
• Arran Montgomery Amick
• Landon B Amick, DPT
• Amicus Health, LLC
• Zachary Thomas Amigo
• Bhavesh R Amin, M.D.
• Deanna C Amma

• Early Intervention Provider Agency in Columbia, SC
• Providers in Columbia, SC by specialty
• Early Intervention Provider Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.