Individual provider Active NPI

Amy Kristine Bronick, FNP

  • Family Medicine Physician
  • Arlington, VA
National Provider Identifier
1982254728
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0024177876 Issued in VA
Practice address
611 S Carlin Springs Rd Ste 309
Arlington, VA 22204-1086
Phone
(703) 671-8444
NPI assigned
Sep 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0024177876 VA Primary

Addresses

Primary practice location

611 S Carlin Springs Rd Ste 309
Arlington, VA 22204-1086

Mailing address

611 S Carlin Springs Rd
Arlington, VA 22204-1064
Phone (703) 671-8444

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0024177876VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1982254728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S CARLIN SPRINGS RD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222041064",
            "telephone_number": "703-671-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S CARLIN SPRINGS RD STE 309",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222041086",
            "telephone_number": "703-671-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONICK",
        "first_name": "AMY",
        "middle_name": "KRISTINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024177876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.