Amy Antle, PA
Individual provider Active NPI Physician Assistant · Lexington, KY
NPI 1831285477 · NPPES record last updated Jan 14, 2022
Key facts
- NPI
- 1831285477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA 118 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050607000228 | KY | Practitioner - Physician Assistant | 1658314026 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 118 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kentucky Mso LLC | Current |
Accepting new patients | |
| Kentucky Mso LLC | Current |
Accepting new patients | |
| University Medical Associates | Past | Accepting new patients | |
| Kentucky Mso LLC | Physician Assistant | Past | Accepting new patients |
| Kindred Recovery PLLC | Past | Accepting new patients | |
| Bluegrass Gastroenterology Associates P.S.C. | Past | Accepting new patients | |
| Womens Gastroenterology Consultants, PSC | Physician Assistant | 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
- amy.antle@hca6.eclinicaldirectplus.com
- amy.antle.1@19475.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 118 | KY | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000374870 | Other | KY | ANTHEM |
| 95000758 | Medicaid | KY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | AMY.ANTLE@hca6.eclinicaldirectplus.com |
Other providers in Lexington, KY
- Lowell Brian Anthony
- Nathan Thomas Anthony
- Starika Anthony
- Izabela Antic
- Pavlina Nicholas Antimisiaris
- Amina Sidrah Anwar
- Mohammed Asaad Anwer
- Kasen Anzelc
- Rony Aouad
- Apex Vision Group PLLC
All providers in Lexington, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.