Individual provider Active NPI

Amy Antle, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1831285477
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 118 Issued in KY
Practice address
160 N Eagle Creek Dr
Lexington, KY 40509-2121
Phone
(859) 263-0022
Fax
(859) 263-4666
NPI assigned
Oct 4, 2006
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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 PA 118 KY Primary

Addresses

Primary practice location

160 N Eagle Creek Dr
Lexington, KY 40509-2121

Mailing address

160 N Eagle Creek Dr
Lexington, KY 40509-2121
Phone (859) 263-0022

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AMY.ANTLE@hca6.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000228 KY Practitioner - Physician Assistant 1658314026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

330 Seven Springs Way
Brentwood, TN 37027-5098

3416 Valley Brook Rd
Nashville, TN 37215-2021

96 C Michael Davenport Blvd
Frankfort, KY 40601-4333

Three Maryland Farms
Suite 250
Brentwood, TN 37027-5053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 118KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Mso LLC CurrentSince Jun 6, 2022 Accepting new patients
Kentucky Mso LLC CurrentSince Jun 6, 2022 Accepting new patients
Womens Gastroenterology Consultants, PSC Physician Assistant Past Accepting new patients
Bluegrass Gastroenterology Associates P.S.C. Past Accepting new patients
University Medical Associates Past Accepting new patients
Kindred Recovery PLLC Past Accepting new patients
Links Orthopedics, LLC Past Accepting new patients

Locations

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660

360 Amsden Ave
Ste 301
Versailles, KY 40383
Phone (859) 873-1303

Interoperability endpoints

  • Direct secure messaging: amy.antle.1@19475.direct.athenahealth.com
  • Direct secure messaging: amy.antle@hca6.eclinicaldirectplus.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1831285477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092121",
            "telephone_number": "859-263-0022",
            "fax_number": "859-263-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092121",
            "telephone_number": "859-263-0022",
            "fax_number": "859-263-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTLE",
        "first_name": "AMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA 118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AMY.ANTLE@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "160 N Eagle Creek Dr",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405092121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.