Individual provider Active NPI

Amy Renea Yankolonis, C.R.N.P

  • Family Nurse Practitioner
  • Hampstead, MD
National Provider Identifier
1851581565
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R167589 Issued in MD
Practice address
4111 Lower Beckleysville Rd Ste C
Hampstead, MD 21074-2248
Phone
(410) 374-0808
NPI assigned
Jul 29, 2007
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 R167589 MD Primary

Addresses

Primary practice location

4111 Lower Beckleysville Rd Ste C
Hampstead, MD 21074-2248

Mailing address

4111 Lower Beckleysville Rd Ste C
Hampstead, MD 21074-2248
Phone (410) 374-0808

Other names 1

  • Ms. Amy Renea Kincaid Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20071127000095 MD Practitioner - Nurse Practitioner 4284722349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R167589MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Laiken, MD, PA CurrentSince May 8, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Saint Joseph Medical Center , Inc. Past Accepting new patients

Locations

4111 Lower Beckleysville Rd
Ste C
Hampstead, MD 21074
Phone (410) 374-0808

4111 Lower Beckleysville Rd
Ste 4
Hampstead, MD 21074
Phone (410) 374-0808

1005 S Main St
Ste A
Hampstead, MD 21074
Phone (410) 374-0808

Interoperability endpoints

  • Direct secure messaging: amy.yankolonis.1@27340.direct.athenahealth.com

Organizations & group practices 4

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": "1185667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1851581565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 LOWER BECKLEYSVILLE RD STE C",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210742248",
            "telephone_number": "410-374-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 LOWER BECKLEYSVILLE RD STE C",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210742248",
            "telephone_number": "410-374-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANKOLONIS",
        "first_name": "AMY",
        "middle_name": "RENEA",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-29",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R167589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "KINCAID",
            "middle_name": "RENEA",
            "prefix": "MS.",
            "credential": "C.R.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampstead, MD

Sources for this page

Verify at the official NPI Registry.