Individual provider Active NPI

Amberly Keyes, PA-C

  • Physician Assistant
  • Fishersville, VA
National Provider Identifier
1447092192
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Baldwin Blvd
Fishersville, VA 22939-2375
Phone
(540) 887-4000
NPI assigned
Jun 12, 2024
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X 5448 SC
Rehabilitation Practitioner 225400000X 5448 SC

Addresses

Primary practice location

100 Baldwin Blvd
Fishersville, VA 22939-2375

Mailing address

100 Baldwin Blvd
Fishersville, VA 22939-2375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20241115000785 SC Practitioner - Physician Assistant 4183158926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Texas Physiatry Services LLCGroup PAC ID 9234628256, 6 clinicians
Impact Physician Group South Carolina LLCGroup PAC ID 9638579352, 7 clinicians

Practice addresses (Care Compare)

20 Pinnacle Pkwy
Elgin, SC 29045-8389
Phone (803) 438-8890

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5448SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physician Group Texas Physiatry Services LLC Physical Medicine & Rehabilitation CurrentSince Sep 1, 2025 Accepting new patients

Locations

20 Pinnacle Pkwy
Elgin, SC 29045
Phone (260) 407-8007

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.

Hospital & facility affiliations 1

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": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1447092192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BALDWIN BLVD",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BALDWIN BLVD",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392375",
            "telephone_number": "540-887-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYES",
        "first_name": "AMBERLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "5448",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "SC",
            "license": "5448",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.