Individual provider Active NPI

Amy Agnes Villa

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1992497515
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5018136 Issued in NC
Practice address
9915 Park Cedar Dr
Charlotte, NC 28210-8905
Phone
(704) 544-3263
NPI assigned
May 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5018136 NC
Nurse Practitioner 363L00000X 5018136 NC Primary

Addresses

Primary practice location

9915 Park Cedar Dr
Charlotte, NC 28210-8905

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20230728000040 NC Practitioner - Nurse Practitioner 5193186831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

9915 Park Cedar Dr
Charlotte, NC 28210-8905
Phone (866) 389-2727

Merit-based Incentive Payment System (MIPS)

Final score
85.46 of 100Reported as group
Quality
80.45
Improvement activities
40
Cost
87.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5018136NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care North Carolina PLLC Family CurrentSince Sep 21, 2025 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Jun 15, 2023 Accepting new patients

Locations

10100 S Main St
Archdale, NC 27263
Phone (336) 431-0715

9915 Park Cedar Dr
Charlotte, NC 28210
Phone (704) 544-3263

9628 Rea Rd
Charlotte, NC 28277
Phone (704) 542-5072

2340 Spring Forest Rd
Raleigh, NC 27615
Phone (919) 790-6401

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

1142 N Broome St
Waxhaw, NC 28173
Phone (701) 843-4680

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1992497515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-5650",
            "fax_number": "704-316-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9915 PARK CEDAR DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108905",
            "telephone_number": "704-544-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "AMY",
        "middle_name": "AGNES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018136",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5018136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.