Amie M Berry, LCSW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

SW9352 Issued in FL

Practice address

4651 Salisbury Road South
4TH Floor, Suite 428
Jacksonville, FL 32256-5506

Phone

(904) 748-9106

Fax

(888) 244-7481

NPI assigned

Nov 19, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amie Thomas, LCSW Professional name

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

59.59 of 100Reported as apm

Quality

59.93

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment Care Compare group NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  FL, GA

  Medicare reassignment Care Compare group NPD
• Gauler & Associates, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
  • NPI 1730405002

  Counselor

  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1558521823
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Avanti Wellness Center Flllp

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1215179056

  Clinical

  NPD (past)
• David C Blackmon,PHD,Psych SVC

  • Clinical Neuropsychologist
  • Jacksonville Beach, FL
  • NPI 1538438270
  NPD (past)

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1508194218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13820 OLD ST. AUGUSTINE ROAD",
            "address_2": "SUITE 113-166",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585506",
            "telephone_number": "904-748-9106",
            "fax_number": "888-247-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SALISBURY ROAD SOUTH",
            "address_2": "4TH FLOOR, SUITE 428",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565506",
            "telephone_number": "904-748-9106",
            "fax_number": "888-244-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "AMIE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9352",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "SW9352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004222300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMIE",
            "last_name": "THOMAS, LCSW",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Duane Ira Bernstein, DMD
• Scott Bernstein, PTA
• Thomas Berquist, MD
• Bedford Hudson Berrey, MD
• Haytza Yanisse Berroteran, R.PH.
• Caitlyn Berry
• Leslie Berry, RD
• Lindsay Berry, OTR/L
• Mary Berry
• Nicole Lynette Berry, PHARM.D.

• Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.