Individual provider Active NPI

Amy Ann Nold, PA-C

  • Physician Assistant
  • Corsicana, TX
National Provider Identifier
1669737425
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07877 Issued in TX
Practice address
400 Hospital Dr Ste 210
Corsicana, TX 75110-2489
Phone
(903) 641-4835
Fax
(903) 641-4846
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA07877 TX Primary

Addresses

Primary practice location

400 Hospital Dr Ste 210
Corsicana, TX 75110-2489

Mailing address

400 Hospital Dr Ste 111
Corsicana, TX 75110-2489
Phone (903) 641-3815

Other practice location 1

800 W Magnolia Ave
Fort Worth, TX 76104-4611
Phone (817) 759-7000

Other practice location 2

1615 Wooded Acres Dr Ste 1
Waco, TX 76710-2863
Phone (254) 229-6815

Other identifiers 3

IdentifierTypeStateIssuer
3043168-03MedicaidTX
8N0473OtherBCBS
3043168-01MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.nold.1@1902.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120821000381 TX Practitioner - Physician Assistant 9537316906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Employee Assistance Program IncGroup PAC ID 1557260064, 102 clinicians

Practice addresses (Care Compare)

108 N Robb St
Trinity, TX 75862-7602
Phone (409) 594-7632

1602 Rock Prairie Rd
College Station, TX 77845-0001

400 Hospital Dr
Corsicana, TX 75110-2489

Hospital & facility affiliations

  • Navarro Regional Hospital Hospital, Corsicana, TX, CCN 450447

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc Physician Assistant CurrentSince Apr 2, 2018 Accepting new patients
Regional Employee Assistance Program Inc Past Accepting new patients

Locations

400 Hospital Dr
Ste 111
Corsicana, TX 75110

400 Hospital Dr
Ste 210
Corsicana, TX 75110
Phone (903) 641-4835

Interoperability endpoints

  • Direct secure messaging: amy.nold.1@1902.direct.athenahealth.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1669737425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR STE 111",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-3815",
            "fax_number": "903-641-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR STE 210",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-4835",
            "fax_number": "903-641-4846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 W Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044611",
            "country_code": "US",
            "telephone_number": "817-759-7000",
            "fax_number": "817-759-7027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1615 Wooded Acres Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767102863",
            "country_code": "US",
            "telephone_number": "254-229-6815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLD",
        "first_name": "AMY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3043168-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N0473",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3043168-01",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.nold.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "400 Hospital Dr Ste 210",
            "city": "Corsicana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751102489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.