Amy Christine Vardaman, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN150639 Issued in GA

Practice address

3788 Idlewild PL
Suwanee, GA 30024-4619

Phone

(404) 273-5225

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1801946876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3788 IDLEWILD PL",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244619",
            "telephone_number": "404-273-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3788 IDLEWILD PL",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244619",
            "telephone_number": "404-273-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDAMAN",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "GA",
            "license": "RN150639",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN150639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID #",
            "identifier": "52058526",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracie R Valera, CEO
• Pamdora Valerio, MSOT, OTR
• Lauren Groves Van Der Sluys, P.T.
• Sarah Elizabeth Vanbuskirk
• Ashley Vanzant, RBT
• Christopher Vardaman
• Catherine Christine Hagan Vargo, DPT
• Jaydev Ranchodji Varma, MD
• Jenna Varner, RBT
• Margarita Vasquez, SLP

• Family Nurse Practitioner in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.