Active NPI
Amy Lynn Tyson, ARNP
- Nurse Practitioner
- Gainesville, FL
National Provider Identifier
1689104267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 9293452
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-0109 - Phone
- (352) 265-0761
- NPI assigned
- Jun 15, 2017
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 9293452 | FL | Primary |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-0109
Mailing address
1600 SW Archer Rd Box 100109
Gainesville, FL 32610-0109
Phone (352) 265-0761
Other practice location 1
870 Patricia Ave
Dunedin, FL 34698-6022
Phone (800) 427-1902
Other practice location 2
870 Patricia Ave
Dunedin, FL 34698-6022
Phone (800) 427-1902
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023160100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9293452 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1689104267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD BOX 100109",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100109",
"telephone_number": "352-265-0761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100109",
"telephone_number": "352-265-0761"
}
],
"practiceLocations": [
{
"address_1": "870 Patricia Ave",
"address_purpose": "LOCATION",
"city": "Dunedin",
"state": "FL",
"postal_code": "346986022",
"country_code": "US",
"telephone_number": "800-427-1902",
"fax_number": "419-531-2664",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "870 Patricia Ave",
"address_purpose": "LOCATION",
"city": "Dunedin",
"state": "FL",
"postal_code": "346986022",
"country_code": "US",
"telephone_number": "800-427-1902",
"fax_number": "419-531-2664",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TYSON",
"first_name": "AMY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-15",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "9293452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023160100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.