Active NPI
Amy R Cianciolo, MD
- Family Medicine Physician
- Anderson, SC
National Provider Identifier
1629095062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20314
- Practice address
- 803 N Fant St
Suite 2a
Anderson, SC 29621-5700 - Phone
- (864) 965-9150
- Fax
- (864) 965-9654
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20314 | SC | Primary |
Addresses
Primary practice location
803 N Fant St
Suite 2a
Anderson, SC 29621-5700
Mailing address
803 N Fant St
Suite 2a
Anderson, SC 29621-5700
Phone (864) 965-9150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203149 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 14, 2015 through Aug 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20314 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anmed Health | Family Medicine | Past | Accepting new patients |
| Anmed Health | 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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- NPI 1255137832
-
- Pediatrics Physician
- Anderson, SC
- NPI 1285667824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477353600000",
"number": "1629095062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 N FANT ST",
"address_2": "SUITE 2A",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296215700",
"telephone_number": "864-965-9150",
"fax_number": "864-965-9654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 N FANT ST",
"address_2": "SUITE 2A",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296215700",
"telephone_number": "864-965-9150",
"fax_number": "864-965-9654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIANCIOLO",
"first_name": "AMY",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2016-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "20314",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203149",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.