Individual provider Active NPI

Amy Michelle Fitzgerald, O.D.

  • Optometrist
  • Saint Joseph, MO
National Provider Identifier
1992893192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03338 Issued in MO
Practice address
2229 N Belt Hwy Ste a
Saint Joseph, MO 64506-2481
Phone
(816) 671-0500
Fax
(816) 671-0600
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03338 MO Primary

Addresses

Primary practice location

2229 N Belt Hwy Ste a
Saint Joseph, MO 64506-2481

Mailing address

2229 N Belt Hwy Ste a
Saint Joseph, MO 64506-2481
Phone (816) 671-0500

Other identifiers 1

IdentifierTypeStateIssuer
27265055OtherBLUECROSSBLUESHIELD

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
T03338MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Rosenak'S Optical Options, Inc. PastSince Nov 3, 2010 Accepting new patients
Eyecare Centers of America Optometrist Past Accepting new patients

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992893192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 N BELT HWY STE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062481",
            "telephone_number": "816-671-0500",
            "fax_number": "816-671-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 N BELT HWY STE A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062481",
            "telephone_number": "816-671-0500",
            "fax_number": "816-671-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "27265055",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.