Individual provider Active NPI

Amy J Payne, LCSW

  • Clinical Social Worker
  • Savannah, GA
National Provider Identifier
1972887214
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007497 Issued in VA
Practice address
1170 Shawnee St
Savannah, GA 31419-1618
Phone
(912) 921-0214
Fax
(843) 579-3846
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904007497 VA Primary

Addresses

Primary practice location

1170 Shawnee St
Savannah, GA 31419-1618

Mailing address

1170 Shawnee St
Savannah, GA 31419-1618
Phone (912) 920-0214

Other practice location 1

620 E Euclid Ave
Suite 101
Lexington, KY 40502-6429
Phone (859) 475-8039

Other identifiers 1

IdentifierTypeStateIssuer
1972887214MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007497VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amypayne@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972887214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 SHAWNEE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191618",
            "telephone_number": "912-920-0214",
            "fax_number": "843-579-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 SHAWNEE ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191618",
            "telephone_number": "912-921-0214",
            "fax_number": "843-579-3846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 E Euclid Ave",
            "address_2": "SUITE 101",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405026429",
            "country_code": "US",
            "telephone_number": "859-475-8039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972887214",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.