Active NPI
Amy Gartland Egan, M.D.
- Clinic/Center
- Bonita Springs, FL
National Provider Identifier
1568618593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- D0058310
- Practice address
- 4811 Island Pond CT Unit 805
Bonita Springs, FL 34134-8780 - Phone
- (301) 943-0820
- NPI assigned
- Aug 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | D0058310 | MD | Primary |
Addresses
Primary practice location
4811 Island Pond CT Unit 805
Bonita Springs, FL 34134-8780
Mailing address
4811 Island Pond CT Unit 805
Bonita Springs, FL 34134-8780
Phone (301) 943-0820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0058310 | MD | MD | Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Clinic/Center | Past | Accepting new patients |
| Endeavor Health Medical Group | Clinic/Center | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
Clinic/Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1568618593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4811 ISLAND POND CT UNIT 805",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341348780",
"telephone_number": "301-943-0820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4811 ISLAND POND CT UNIT 805",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341348780",
"telephone_number": "301-943-0820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGAN",
"first_name": "AMY",
"middle_name": "GARTLAND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-11",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "MD",
"license": "D0058310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.