Individual provider Active NPI

Amy Marie Head, NP-C

  • Family Nurse Practitioner
  • Griffin, GA
National Provider Identifier
1740567809
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN144931 Issued in GA
Practice address
1657 N Expressway
Griffin, GA 30223-1276
Phone
(770) 228-2641
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN144931 GA Primary

Addresses

Primary practice location

1657 N Expressway
Griffin, GA 30223-1276

Mailing address

1657 N Expressway
Griffin, GA 30223-1276
Phone (770) 631-9292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20120124000932 GA Practitioner - Nurse Practitioner 3274700760

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1740567809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 N EXPRESSWAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231276",
            "telephone_number": "770-631-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 N EXPRESSWAY",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302231276",
            "telephone_number": "770-228-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN144931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.