Amy Lee Farside, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00433500 Issued in NJ

Practice address

310 Chris Gaupp Dr Ste 102
Galloway, NJ 08205-4461

Phone

(609) 652-9933

NPI assigned

Jul 16, 2015

Sex

Female

Sole proprietor

Yes

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 NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608
  Medicare reassignment NPD
• Atlanticare Physician Group

  dba AtlantiCare Urgent Care

  • Clinical Social Worker
  • Egg Harbor Township, NJ
  • NPI 1881618494
  NPD
• Atlanticare Physician Group, PA

  dba AtlantiCare Urgent Care

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1891179156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 POST RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083609313",
            "telephone_number": "609-319-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CHRIS GAUPP DR STE 102",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054461",
            "telephone_number": "609-652-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARSIDE",
        "first_name": "AMY",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00433500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Empowerment Recovery Services, LLC
• Family Empowerment Recovery Services, LLC
• Family Service Association
• Dana Jean Famularo, M.S.CCC-SLP
• Lauren C Farquhar, MS
• David S Fascia, RPH CCP
• Feet First of New Jersey LLC
• Fidelity Plus Care, LLC.
• Dominique Marie Fields, PHARMD
• Walter M. Finken Jr., D.M.D.

• Family Nurse Practitioner in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.