Amy Jeanette Dievendorf, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4341SC Issued in SC

Practice address

1655 Bernardin Avenue
Suite - 350
Columbia, SC 29204

Phone

(803) 253-7575

Fax

(803) 253-7571

NPI assigned

Sep 28, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

University of South Carolina School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CH Specialty Services SC LLCGroup PAC ID 6608182993, 222 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CH Specialty Services SC LLC

  • Family Nurse Practitioner
  • North Charleston, SC
  • NPI 1275915522
  Medicare reassignment Care Compare group NPD
• Curana Health of South Carolina PC

  • Internal Medicine Physician
  • North Charleston, SC
  • NPI 1316477896
  Medicare reassignment NPD
• Providence Group Practices II, LLC

  • Interventional Cardiology Physician
  • Columbia, SC
  • NPI 1396192001
  NPD (past)

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1871802686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "address_2": "SUITE - 425",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7878",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVENUE",
            "address_2": "SUITE - 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29204",
            "telephone_number": "803-253-7575",
            "fax_number": "803-253-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEVENDORF",
        "first_name": "AMY",
        "middle_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "4341SC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Dickson, N.P.
• Gracie Margarita Diego-Marroquin
• Taylor C Dieter, DNP, NP-C
• Sandra Dietrich, RD
• Ashley Dietze
• Lindell D Diez
• Levi Caleb Diggins, DO
• Robert Shawn Diggs, LCSW
• Grace Digiacomo, RBT
• Digital Derm, Inc

• Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.