Individual provider Active NPI

Amy M Johnson, PA-C

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1700985793
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1922 Issued in TN
Practice address
310 25TH Ave N
Ste 204
Nashville, TN 37203-1515
Phone
(615) 620-5151
Fax
(615) 620-5155
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC038 KY
Physician Assistant 363A00000X PA985 KY
Physician Assistant 363A00000X 1922 TN Primary

Addresses

Primary practice location

310 25TH Ave N
Ste 204
Nashville, TN 37203-1515

Mailing address

515 Stonecrest Pkwy
Ste 210
Smyrna, TN 37167-6826
Phone (615) 625-7112

Other identifiers 1

IdentifierTypeStateIssuer
1522269MedicaidTN

Other names 1

  • Miss Amy M Green Other name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000295 TN Practitioner - Physician Assistant 4284631060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1922TNMDMental Health Counselor
PA985KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Jan 1, 2022 Accepting new patients
Saint Thomas Medical Partners CurrentSince Jan 1, 2022 Accepting new patients
Centennial Pediatrics PC PastSince Oct 1, 2012 Accepting new patients

Locations

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

2011 Murphy Ave
Ste 200
Nashville, TN 37203
Phone (615) 301-1000

300 20th Ave N
Fl 9
Nashville, TN 37203

Interoperability endpoints

  • Direct secure messaging: amy.johnson.1@7654.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1700985793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 STONECREST PKWY",
            "address_2": "STE 210",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676826",
            "telephone_number": "615-625-7112",
            "fax_number": "615-625-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 25TH AVE N",
            "address_2": "STE 204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031515",
            "telephone_number": "615-620-5151",
            "fax_number": "615-620-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC038",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA985",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522269",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GREEN",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.