NPIMap

Individual provider Active NPI

Amy Leigh Gryder

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1407579931
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32024 Issued in TN
Practice address
9352 Park West Blvd
Knoxville, TN 37923-4325
Phone
(865) 373-1000
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32024 TN Primary

Addresses

Primary practice location

9352 Park West Blvd
Knoxville, TN 37923-4325

Mailing address

3334 Song Sparrow Dr
Maryville, TN 37803-6905
Phone (252) 266-8761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221216000966 TN Practitioner - Nurse Practitioner 0840669651
I20230627003082 AZ Practitioner - Nurse Practitioner 0840669651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bullhead City Clinic CorpGroup PAC ID 1052317575, 23 clinicians
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2500 Canyon Rd
Bullhead City, AZ 86442-8624

2585 Miracle Mile
Bullhead City, AZ 86442-7522

2735 Silver Creek Rd
Bullhead City, AZ 86442-7924
Phone (928) 763-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
50.84 of 100Reported as group
Quality
7.69
Promoting interoperability
100
Improvement activities
0
Cost
78.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32024TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bullhead City Clinic Corp CurrentSince Aug 1, 2023 Accepting new patients
Statcare Inpatient LLC CurrentSince Dec 1, 2022 Accepting new patients
Northwest Urgent Care LLC CurrentSince Dec 3, 2023 Accepting new patients
Bullhead City Clinic Corp CurrentSince Aug 1, 2023 Accepting new patients

Locations

2500 Canyon Rd
Bldg B
Bullhead City, AZ 86442
Phone (928) 444-1444

3699 Highway 95
Ste 500
Bullhead City, AZ 86442
Phone (928) 278-6211

2500 Canyon Rd
Ste B2
Bullhead City, AZ 86442
Phone (928) 763-9290

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

3699 Highway 95
Ste 50050
Bullhead City, AZ 86442

3870 W River Rd
Ste 126
Tucson, AZ 85741
Phone (520) 209-7000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

Interoperability endpoints

  • Direct secure messaging: amy.gryder.1@1575.direct.athenahealth.com
  • Direct secure messaging: amy.gryder.1@1576.direct.athenahealth.com

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.

Hospital & facility affiliations 7

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1407579931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 SONG SPARROW DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378036905",
            "telephone_number": "252-266-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9352 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234325",
            "telephone_number": "865-373-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYDER",
        "first_name": "AMY",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.