NPIMap

Individual provider Active NPI

Marie I Amico, N.P.

  • Nurse Practitioner
  • Stanley, VA
National Provider Identifier
1740513118
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0017139514 Issued in VA
Practice address
235 Medical Dr
Stanley, VA 22851-4112
Phone
(540) 778-4259
NPI assigned
Sep 16, 2009
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0017139514 VA Primary

Addresses

Primary practice location

235 Medical Dr
Stanley, VA 22851-4112

Mailing address

220 Campus Blvd Ste 200
Winchester, VA 22601-2889
Phone (540) 536-5100

Other identifiers 1

IdentifierTypeStateIssuer
P01540333OtherVARR MEDICARE

Other names 1

  • Marie I Jackson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mamico124244@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100113000861 VA Practitioner - Nurse Practitioner 7315088234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Page Memorial Hospital IncGroup PAC ID 8426951203, 81 clinicians

Practice addresses (Care Compare)

235 Medical Dr
Stanley, VA 22851-4112
Phone (540) 778-4259

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0017139514VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Page Memorial Hospital, Inc. Current Accepting new patients
Page Memorial Hospital Inc. CurrentSince Feb 27, 2023 Accepting new patients

Locations

125 Memorial Dr
Luray, VA 22835
Phone (540) 743-2282

135 Memorial Dr
Luray, VA 22835
Phone (540) 743-2887

235 Medical Dr
Stanley, VA 22851
Phone (540) 778-3484

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

220 Campus Blvd
Ste 200
Winchester, VA 22601
Phone (540) 536-0307

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Interoperability endpoints

  • Direct secure messaging: mamico124244@soc.inova.org
  • Direct secure messaging: mamico124244@valleyhealth.direct-ci.com
  • Direct secure messaging: marie.amiconp.p2@direct.msmg.nextgenshare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1740513118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 200",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012889",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MEDICAL DR",
            "city": "STANLEY",
            "state": "VA",
            "postal_code": "228514112",
            "telephone_number": "540-778-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMICO",
        "first_name": "MARIE",
        "middle_name": "I",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0017139514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01540333",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mamico124244@soc.inova.org",
            "affiliation": "N",
            "address_1": "235 Medical Dr",
            "city": "Stanley",
            "state": "VA",
            "country_code": "US",
            "postal_code": "228514112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "JACKSON",
            "middle_name": "I",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stanley, VA

Sources for this page

Verify at the official NPI Registry.