Individual provider Active NPI

Amy Fidler

  • School Social Worker
  • Clarksville, TN
National Provider Identifier
1609228543
Registry record updated Jul 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Practice address
1820 Memorial Cir
Clarksville, TN 37043-4539
Phone
(931) 920-7300
NPI assigned
Jul 4, 2016
Last updated
Jul 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X Primary

Addresses

Primary practice location

1820 Memorial Cir
Clarksville, TN 37043-4539

Mailing address

3715 Windmill CT
Clarksville, TN 37040-1301
Phone (334) 494-2995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200929001858 TN Practitioner - Clinical Social Worker 3476972225 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7223TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Jun 26, 2020 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince Jun 26, 2020 Accepting new patients

Locations

1820 Memorial Cir
Clarksville, TN 37043
Phone (931) 648-9976

511 8th St
Clarksville, TN 37040
Phone (615) 595-8383

4160 Ocoee St N
Ste 8
Cleveland, TN 37312
Phone (423) 362-3111

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467590400000",
    "number": "1609228543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 WINDMILL CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401301",
            "telephone_number": "334-494-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL CIR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434539",
            "telephone_number": "931-920-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDLER",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-04",
        "last_updated": "2016-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.