Individual provider Active NPI

Amy Jeanette Villachica, APRN, FNP-C

  • Family Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1558089920
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11021227 Issued in FL
Practice address
4910 N 12TH Ave
Pensacola, FL 32504-8972
Phone
(850) 494-4600
Fax
(850) 433-8940
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 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 11021227 FL Primary

Addresses

Primary practice location

4910 N 12TH Ave
Pensacola, FL 32504-8972

Mailing address

4548 Dawn Dr
Milton, FL 32583-9292
Phone (850) 510-0847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230118002621 FL Practitioner - Nurse Practitioner 8527439140 Reassigns benefits to 1 organization

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
Pensacola Primary Care IncGroup PAC ID 6002718343, 21 clinicians

Practice addresses (Care Compare)

4910 N 12TH Ave
Pensacola, FL 32504-8972
Phone (850) 494-4600

Hospital & facility affiliations

  • Mission Home Health LLC Home health agency, Pensacola, FL, CCN 687091
  • HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11021227FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Primary Care Inc CurrentSince Dec 5, 2022 Accepting new patients
Pensacola Primary Care Inc CurrentSince Dec 5, 2022 Accepting new patients
Pensacola Primary Care, Inc. Past Accepting new patients

Locations

1190 E Nine Mile Rd
Pensacola, FL 32514
Phone (850) 474-8771

8333 N Davis Hwy
Pensacola, FL 32514
Phone (850) 474-8000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: amy.villachica@hca5.eclinicaldirectplus.com

Organizations & group practices 3

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 4

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1558089920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4548 DAWN DR",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325839292",
            "telephone_number": "850-510-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048972",
            "telephone_number": "850-494-4600",
            "fax_number": "850-433-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACHICA",
        "first_name": "AMY",
        "middle_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11021227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.