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AMY DESTEFANO MD
NPI 1154421188
Emergency Medicine in Raleigh, NC

Active since September 22, 2006
4420 LAKE BOONE TRL, RALEIGH, NC 27607(919) 784-3100 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2023, Mar 29, 2021 (2 updates tracked since 2021).

About Amy Destefano Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMY DESTEFANO MD (NPI 1154421188) is an individual emergency medicine provider in Raleigh, North Carolina, licensed in North Carolina (36096) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1154421188
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameAMY DESTEFANOCredential: MD
Location Address4420 LAKE BOONE TRLRaleigh, NC 27607-7505
Mailing Address2501 Blue Ridge Rd Ste 250Raleigh, NC 27607-6346 · (919) 863-4128
Phone(919) 784-3100
Sole ProprietorNo
Enumeration DateSeptember 22, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedMarch 29, 2021
✔ NPI 1154421188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in NC · 36096
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
4420 LAKE BOONE TRL, Raleigh, NC 27607
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Other Identifiers 3

Medicaid891041MNC
Other1041MNC · Blue Shield
OtherP00184463NC · Rr Medicare

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NADER CYRUS EMAMI-KELISHADI PA
Physician Assistant
4420 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (703) 585-0860
ERIC LINTON
Nurse Anesthetist, Certified Registered
4420 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (919) 784-3100
JOSHUA DAVID FISHER FNP
Nurse Practitioner (Family)
4420 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (919) 784-3100
MALLORY WOLTERING RN
Registered Nurse (Critical Care Medicine)
4420 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (919) 784-3100
JOHN O COLLINS M.D.
Psychiatry & Neurology (Neurology)
4420 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (919) 784-7093
ERIN D RUSINEK PA-C
Physician Assistant
4420 LAKE BOONE TRL, SUITE 200
RALEIGH, NC 27607
Wake County (919) 784-6818
DONNA RANSOM CRNA
Nurse Anesthetist, Certified Registered
4420 LAKE BOONE TRL
RALEIGH, NC 27607
Wake County (919) 784-3034
JOELLEN C SPECA M.D.
Internal Medicine (Hematology & Oncology)
4420 LAKE BOONE TRL, SUITE 200
RALEIGH, NC 27607
Wake County (919) 784-6818

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Destefano's NPI number?

The NPI number for Amy Destefano is 1154421188. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Where is Amy Destefano located?

Amy Destefano practices at 4420 Lake Boone Trl, Raleigh, NC 27607. The listed phone number is (919) 784-3100.

What is Amy Destefano's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

When was this NPI record last updated?

The NPPES record for Amy Destefano was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.