AMY BERGQUIST FNP-BC
NPI 1366119364
Nurse Practitioner - Family in Carrollton, GA

Q: What is Amy Bergquist's NPI number?

The NPI number for Amy Bergquist is 1366119364. It was assigned to this individual provider in the NPPES registry on August 26, 2021.

Q: What is Amy Bergquist's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amy Bergquist was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since August 26, 2021PECOS EnrolledAccepts Medicare Assignment

706 DIXIE ST STE 320, CARROLLTON, GA 30117(770) 812-9326(770) 836-9358 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 10, 2025, Aug 30, 2022, Aug 26, 2021 (3 updates tracked since 2021).

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About Amy Bergquist Fnp-bc NPPES

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

AMY BERGQUIST FNP-BC (NPI 1366119364) is an individual family provider in Carrollton, Georgia, licensed in Georgia (APRN-NP230576) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1366119364

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMY BERGQUISTCredential: FNP-BC

Location Address706 DIXIE ST STE 320Carrollton, GA 30117-3890

Mailing Address1196 Sandhill Hickory Lvl RdCarrollton, GA 30116-8158 · (404) 784-2675

Phone(770) 812-9326

Fax(770) 836-9358

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 26, 2021

Last NPPES UpdateOctober 10, 20253 updates tracked since enumeration

NPPES CertifiedOctober 10, 2025

✔ NPI 1366119364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · APRN-NP230576

706 DIXIE ST STE 320, Carrollton, GA 30117

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amy Bergquist Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143626424

PECOS Enrollment IDI20210913001046

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Amy Bergquist reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tanner Medical Group Inc

1.4 mi

Cardiovascular Disease

100 GREENWAY BLVD FL 2
Carrollton, GA 30117

Reassigned Medicare billing, Georgia enrollment
232 clinicians in this Medicare group

NPI 1396979787 (770) 838-8710

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

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

RONDA S PHILLIPS NP

Nurse Practitioner