Amy Louise Crittenden, FNP-BC is a medicare enrolled "Nurse Practitioner" physician in Mount Airy, North Carolina. Her current practice location is
401 Technology Ln, Mount Airy, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 789-2922.
Amy Louise Crittenden is licensed to practice in North Carolina (license number 5011653) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164985008.
Physician's Profile
| Full Name | Amy Louise Crittenden |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 401 Technology Ln, Mount Airy, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164985008
- Provider Enumeration Date: 04/08/2019
- Last Update Date: 05/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 2668715749
- Enrollment ID: I20190513000172
Medical Identifiers
Medical identifiers for Amy Louise Crittenden such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164985008 | NPI | - | NPPES |
| 5011653 | Other | NC | NORTH CAROLINA BOARD OF NURSING |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QH0002X | Family Medicine - Hospice And Palliative Medicine | 5011653 (North Carolina) | Secondary |
| 363L00000X | Nurse Practitioner | 5011654 (North Carolina) | Secondary |
| 363L00000X | Nurse Practitioner | 5011653 (North Carolina) | Primary |
| 363L00000X | Nurse Practitioner | 0024177837 (Virginia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5011653 (North Carolina) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amy Louise Crittenden allows following entities to bill medicare on her behalf.
| Entity Name | North Carolina Kidney Care Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164028940
PECOS PAC ID: 8729491097
Enrollment ID: O20210105001361 |
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| Entity Name | Monogram Health Professional Services Of North Carolina Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366162885
PECOS PAC ID: 9335517176
Enrollment ID: O20221129000129 |
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| Entity Name | Care Solutions Of Nc Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235919283
PECOS PAC ID: 5597114819
Enrollment ID: O20231212003523 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Louise Crittenden is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amy Louise Crittenden, FNP-BC
401 Technology Ln Ste 200,
Mount Airy, NC 27030-5040
Ph: (336) 789-2922 | Amy Louise Crittenden, FNP-BC
401 Technology Ln,
Mount Airy, NC 27030-5039
Ph: (336) 789-2922 |
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