Individual provider Active NPI

Amaya Johnson McCarthy, ARNP

  • Family Nurse Practitioner
  • Fernandina Beach, FL
National Provider Identifier
1720623275
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11006158 Issued in FL
Practice address
22455 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone
(904) 572-1884
Fax
(904) 491-1118
NPI assigned
Nov 7, 2019
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11006158 FL Primary
Emergency Registered Nurse 163WE0003X RN9317044 FL

Addresses

Primary practice location

22455 Flora Parke Xing
Fernandina Beach, FL 32034-8000

Mailing address

130 N 18TH St
Fernandina Beach, FL 32034-2651
Phone (912) 467-2640

Other practice location 1

130 N 18th St
Fernandina Beach, FL 32034-2651
Phone (912) 467-2640

Other practice location 2

96279 Brady Point Rd
Fernandina Beach, FL 32034-7076
Phone (904) 527-1884

Other names 1

  • Amaya Johnson McCarthy Former name

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
I20220815002669 FL Practitioner - Nurse Practitioner 0042693665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 549-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9317044FLMDEmergency Registered Nurse
APRN11006158FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Aug 8, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 8, 2022 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: amccarthy587378@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1720623275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N 18TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320342651",
            "telephone_number": "912-467-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22455 FLORA PARKE XING",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348000",
            "telephone_number": "904-572-1884",
            "fax_number": "904-491-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 N 18th St",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320342651",
            "country_code": "US",
            "telephone_number": "912-467-2640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "96279 Brady Point Rd",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320347076",
            "country_code": "US",
            "telephone_number": "904-527-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "AMAYA",
        "middle_name": "JOHNSON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006158",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN9317044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMAYA",
            "last_name": "MCCARTHY",
            "middle_name": "JOHNSON",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.