Individual provider Active NPI

Amy C Flint, PA

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1720336712
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110517 Issued in FL
Practice address
301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631
Phone
(423) 794-5590
Fax
(423) 794-5877
NPI assigned
Aug 22, 2012
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2173 TN
Physician Assistant 363A00000X PA9110517 FL Primary

Addresses

Primary practice location

301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631

Mailing address

1 Hospital Dr Ste 4200
Asheville, NC 28801-4550
Phone (828) 213-4600

Other practice location 1

303 Med Tech Pkwy Ste 150
Johnson City, TN 37604-2394
Phone (423) 282-8070

Other identifiers 2

IdentifierTypeStateIssuer
1528534MedicaidTN
1532063MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address missionhealth@direct.msj.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200825002200 FL Practitioner - Physician Assistant 9638314693 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 15, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 15, 2020 Accepting new patients
Circe Medical Services LLC Past Accepting new patients
Boiling Spring Lakes Family Medicine, PC PastSince Dec 1, 2019 Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Aug 18, 2019 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#100108
Gainesville, FL 32610
Phone (352) 265-0680

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16348/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1720336712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR STE 4200",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014550",
            "telephone_number": "828-213-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 120",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042631",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Med Tech Pkwy Ste 150",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042394",
            "country_code": "US",
            "telephone_number": "423-282-8070",
            "fax_number": "423-282-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLINT",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-22",
        "last_updated": "2022-01-07",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2173",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528534",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532063",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "missionhealth@direct.msj.org",
            "affiliation": "N",
            "address_1": "303 Med Tech Pkwy Ste 150",
            "city": "Johnson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376042394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.