NPIMap

Individual provider Active NPI

Amber O Vick, MD

  • Family Medicine Physician
  • New London, MN
National Provider Identifier
1972519213
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48788 Issued in MN
Practice address
600 Peterson Parkway
Affiliated Community Medical Centers
New London, MN 56273
Phone
(320) 354-2222
Fax
(218) 529-9120
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 48788 MN Primary

Addresses

Primary practice location

600 Peterson Parkway
Affiliated Community Medical Centers
New London, MN 56273

Mailing address

600 Peterson Parkway
Affiliated Community Medical Centers
New London, MN 56273
Phone (320) 354-2222

Other identifiers 4

IdentifierTypeStateIssuer
01-25488OtherMNMEDICA
165H7HOOtherMNBCBSMN
P00442141OtherRR MEDICARE PTAN
985172000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060808000415 MN Practitioner - Family Practice 2567465776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

600 Peterson Pkwy
New London, MN 56273-7823
Phone (320) 354-2222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Nov 1, 2021 Accepting new patients
Carris Health LLC Past Accepting new patients

Locations

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: avick29841@direct.centracare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1972519213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PETERSON PARKWAY",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "56273",
            "telephone_number": "320-354-2222",
            "fax_number": "218-529-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PETERSON PARKWAY",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "56273",
            "telephone_number": "320-354-2222",
            "fax_number": "218-529-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "AMBER",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "48788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-25488",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "165H7HO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P00442141",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "985172000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, MN

Sources for this page

Verify at the official NPI Registry.