AMY WYATT ROSENBLUM (NPI# 1619286424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619286424 |
| Entity Type | Individual |
| Full Name | AMY WYATT ROSENBLUM |
| Other Name | AMY LYNN WYATT |
| Credential | PA-C |
| Practice Address |
15237 Creativity Dr Culpeper VA 22701 |
| Mailing Address |
Po Box 21975 Belfast ME 04915-4116 |
| Practice Telephone | 5403214281 |
| Mailing Telephone | 5403214281 |
| Mailing Fax Number | 5403214282 |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2020-10-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | DT07529 | VA | Dietary & Nutritional Service Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1619286424 | 05 | |
| VA | MEDICARE | VVS807A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2503 S Seminole Trl, Madison, VA 227272690 | 5409486871 | |
| 541 Sunset Ln Ste 301, Culpeper, VA 227013979 | 5408254557 | |
| 125 N Main St, Madison, VA 227273057 | 5409486861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548811268 | Amy K Rosenblum | Behavioral Analyst | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2019-09-24 |
| Street Address |
15237 CREATIVITY DR |
| City | CULPEPER |
| State | VA |
| Zip Code | 22701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871599464 | Stacey L Ratigan | Legal Medicine | 15237 Creativity Dr, Culpeper, VA 22701 | 2005-06-28 |
| 1477179257 | Carmella Walling | Nurse Practitioner | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2020-06-17 |
| 1124678479 | Abigail Rennie Carruthers | Physician Assistant | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2019-09-18 |
| 1518440825 | Heather Lynn Cannova | Nurse Practitioner | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2018-09-12 |
| 1396224218 | Amber D. Mullins | Nurse Practitioner | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2018-08-10 |
| 1053897967 | Erin Nicole Jones | Physician Assistant | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2018-07-13 |
| 1356874275 | Ridgeline Physician Services, LLC | Family Medicine | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2017-04-07 |
| 1073966156 | Shenandoah Family Urgent Care, LLC | Clinic/Center | 15237 Creativity Dr, Suite 103, Culpeper, VA 22701-2504 | 2016-07-13 |
| 1295188373 | Shenandoah Family Practice, LLC | Clinic/Center | 15237 Creativity Dr, Suite 101, Culpeper, VA 22701-2504 | 2016-07-13 |
| 1578873394 | Thomas E Achter Jr. | Nurse Practitioner | 15237 Creativity Dr, Culpeper, VA 22701-2504 | 2010-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720621907 | Warzetta Delphina Carter | Technician | 1415 Orange Rd., Culpeper, VA 22701 | 2019-10-21 |
| 1043747983 | Jeremy L. Mccullough | Physical Therapist | 15331 Creativity Dr # 960, Culpeper, VA 22701 | 2017-05-22 |
| 1013366921 | Angel Wings Family Services LLC. | Home Health | 133 East Davis Street Suite 330, Culpeper, VA 22701 | 2016-06-10 |
| 1598114654 | Aa Lightfoot Transportation | Non-emergency Medical Transport (VAN) | 13908 Eggbornsville Rd, Culpeper, VA 22701 | 2016-06-09 |
| 1780087437 | Healing Hands Therapeutic Massage, LLC. | Massage Therapist | 530 Sunset Lane, Culpeper, VA 22701 | 2014-10-08 |
| 1053694893 | Sharon Darling | Pharmacist | 309 Southgate Sc, Culpeper, VA 22701 | 2011-09-27 |
| 1821371196 | Cathy Annette Crain | Pharmacist | 309 Southgate, Safeway Pharmacy, Culpeper, VA 22701 | 2011-09-23 |
| 1447572698 | Jordan Lee Nougaret | Specialist/Technologist | 132 Standpipe Road, Culpeper, VA 22701 | 2010-02-15 |
| 1194957324 | Giant Food Stores, LLC | Pharmacy | 15371 Montanus Drive, Culpeper, VA 22701 | 2009-08-21 |
| 1093959611 | Samantha Jane Reynolds | Physician Assistant | 1100 Sunset Lane 1211-a, Culpeper, VA 22701 | 2009-04-27 |
| Find all providers in zip 22701 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124638986 | Courtney Anne Kassner | Physician Assistant | 2706 Davis Ave, Alexandria, VA 22302-2817 | 2020-08-06 |
| 1295356145 | Nilofar Ariasaif | Physician Assistant | 15401 Bald Eagle Ln, Woodbridge, VA 22191-3782 | 2020-05-01 |
| 1396366555 | Sheelon Aghili | Physician Assistant | 5801 Hampton Forest Way, Fairfax, VA 22030-7254 | 2020-04-29 |
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1902432644 | Madison Alexis Cooper | Physician Assistant | 920 Battlefield Blvd S Ste 101, Chesapeake, VA 23322-4254 | 2020-03-13 |
| 1285296111 | Kimberly Stewart Hugo | Physician Assistant | 10932 Point Grey Road, Henrico, VA 23233-2429 | 2019-07-01 |
| 1558824698 | Jessica Leigh Pacuch | Physician Assistant | 2440 Raphine Rd, Raphine, VA 24472-2541 | 2019-04-06 |
| 1073074431 | Nicholas Alexander Jones | Physician Assistant | 924 Parley Pl, Chesapeake, VA 23323-4135 | 2019-03-28 |
| 1003371410 | Ryan Timothy Pyles | Physician Assistant | 25 Commerce Park Drive, Raphine, VA 24472 | 2019-02-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.