NPIMap

Individual provider Active NPI

Amy Van Vooren, P.A.

  • Physician Assistant
  • Wilson, NC
National Provider Identifier
1811984974
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103186 Issued in NC
Practice address
1705 S. Tarboro Street
Wilson, NC 27893-3428
Phone
(252) 933-8928
Fax
(252) 399-7477
NPI assigned
Oct 4, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103186 NC Primary

Addresses

Primary practice location

1705 S. Tarboro Street
Wilson, NC 27893-3428

Mailing address

P O Box 12156
Newport News, VA 23612-2156
Phone (757) 867-6502

Other identifiers 1

IdentifierTypeStateIssuer
2764245OtherNCMEDICARE CORE

Other names 1

  • Amy J Monroe Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050929000879 NC Practitioner - Physician Assistant 0042245805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
R Franklin University of Med & Sci/Chicago Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

721 Tilghman Dr
Suite 100
Dunn, NC 28334-6066
Phone (910) 892-5635

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103186NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NC Emergency Physician Partners PLLC Physician Assistant Past Accepting new patients
Henderson Emergency Physicians, PLLC Past Accepting new patients
Franklin Regional Emergency Physicians PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amy.van.vooren.1@25810.direct.athenahealth.com
  • Direct secure messaging: amyvanvooren@gvhs.allscriptsdirect.net

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.

Hospital & facility affiliations 3

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811984974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 12156",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236122156",
            "telephone_number": "757-867-6502",
            "fax_number": "757-867-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 S. TARBORO STREET",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-933-8928",
            "fax_number": "252-399-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VOOREN",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORE",
            "identifier": "2764245",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MONROE",
            "middle_name": "J",
            "credential": "P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.