Individual provider Active NPI

Amy Melinda Sanderson, APRN

  • Family Nurse Practitioner
  • Richmond, KY
National Provider Identifier
1598079675
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006515 Issued in KY
Practice address
789 Eastern Byp
Suite 14
Richmond, KY 40475-2415
Phone
(859) 625-0900
Fax
(859) 625-0995
NPI assigned
Aug 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1112888 KY
Nurse Practitioner 363L00000X 3006515 KY
Family Nurse Practitioner 363LF0000X 3006515 KY Primary

Addresses

Primary practice location

789 Eastern Byp
Suite 14
Richmond, KY 40475-2415

Mailing address

4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3062
Phone (859) 625-0900

Other identifiers 1

IdentifierTypeStateIssuer
7100136150OtherKYMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100929000802 KY Practitioner - Nurse Practitioner 6002932860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kiosk Medicine Kentucky LLCGroup PAC ID 6002887510, 169 clinicians

Practice addresses (Care Compare)

890 Richmond PLZ
Richmond, KY 40475-2564
Phone (859) 623-5155

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
66.02
Promoting interoperability
100
Improvement activities
40
Cost
79.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1112888KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Jan 27, 2017 Accepting new patients
North Lexington Urgent Treatment Associates PSC Nurse Practitioner Past Accepting new patients

Locations

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

890 Richmond Plz
Richmond, KY 40475
Phone (859) 623-5155

Interoperability endpoints

  • Direct secure messaging: amy.sanderson@krogerhealth.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1598079675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR",
            "address_2": "SUITE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173062",
            "telephone_number": "859-625-0900",
            "fax_number": "859-625-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 EASTERN BYP",
            "address_2": "SUITE 14",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752415",
            "telephone_number": "859-625-0900",
            "fax_number": "859-625-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "AMY",
        "middle_name": "MELINDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1112888",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3006515",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "7100136150",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

Verify at the official NPI Registry.