Amy Whittlesey

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

17627 Issued in TN

Practice address

325 N State of Franklin Rd
Ground Floor
Johnson City, TN 37604-6056

Phone

(423) 439-7320

Fax

(423) 439-7343

NPI assigned

Sep 4, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  Medicare reassignment NPD

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1487903654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "address_2": "GROUND FLOOR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046056",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTLESEY",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q013266",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Brooke Whitmore, PHARM.D.
• Laura M Whitson, MSW
• Holly Whitt
• Skylar Brackett Whittenbarger
• Riley H Whittington, APN
• Whynot Chiropractic Clinic PC
• Dwight Carson Whynot, DC
• Jennifer Ann Widener, PHARMD
• Shannon M Wiederholt, RD,LDN,CDE
• Clifford Frank Wiegand, MD

• Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.