Individual provider Active NPI

Amanda Drake Myers, DNP, FNP-C

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1619490372
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009697 Issued in NC
Practice address
12610 N Community House Rd Ste 100
Charlotte, NC 28277-3892
Phone
(704) 752-3730
Fax
(704) 752-9056
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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 5009697 NC Primary

Addresses

Primary practice location

12610 N Community House Rd Ste 100
Charlotte, NC 28277-3892

Mailing address

205 N Main St
Wingate, NC 28174-8287

Other practice location 1

205 N Main St
Wingate, NC 28174-8287
Phone (704) 233-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190205003491 NC Practitioner - Nurse Practitioner 6901144674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Urology Partners PLLCGroup PAC ID 8921280587, 37 clinicians

Practice addresses (Care Compare)

12610 N Community House Rd
Suite 100
Charlotte, NC 28277-3892
Phone (704) 752-3730

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5009697NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Urology Partners PLLC CurrentSince Jan 28, 2019 Accepting new patients
Carolina Urology Partners, PLLC Past Accepting new patients

Locations

12610 N Community House Rd
Ste 100
Charlotte, NC 28277
Phone (704) 610-3220

10650 Park Rd
Ste 130
Charlotte, NC 28210
Phone (704) 752-3730

9735 Kincey Ave
Ste 302
Huntersville, NC 28078
Phone (704) 414-2870

9735 Kincey Ave
Ste 201
Huntersville, NC 28078
Phone (704) 414-2865

Interoperability endpoints

  • Direct secure messaging: amanda.myers.p1@direct.cup.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: amyers832859@carolinashealthcaresystem.direct-ci.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": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1619490372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N MAIN ST",
            "city": "WINGATE",
            "state": "NC",
            "postal_code": "281748287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12610 N COMMUNITY HOUSE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773892",
            "telephone_number": "704-752-3730",
            "fax_number": "704-752-9056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N Main St",
            "address_purpose": "LOCATION",
            "city": "Wingate",
            "state": "NC",
            "postal_code": "281748287",
            "country_code": "US",
            "telephone_number": "704-233-8102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "AMANDA",
        "middle_name": "DRAKE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.