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AMY JILL FORMBY
NPI 1861062200
Registered Nurse in Birmingham, AL

Active since June 28, 2021Accepts Medicare Assignment
800 LAKESHORE DR, BIRMINGHAM, AL 35229(205) 726-2401 Get Directions Write a Review

NPPES record last updated: June 28, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Amy Jill Formby NPPES

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

AMY JILL FORMBY (NPI 1861062200) is an individual registered nurse in Birmingham, Alabama, licensed in Alabama (1-126419) and active in the NPI registry since June 2021. She is a graduate of Other (2022).

NPPES Registry Identity

NPI1861062200
Entity TypeIndividualFemale
Primary Taxonomy163W00000X
Provider Legal NameAMY JILL FORMBY
Location Address800 LAKESHORE DRBirmingham, AL 35229-0001
Mailing Address800 Lakeshore DrBirmingham, AL 35229-0001 · (205) 726-2401
Phone(205) 726-2401
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 28, 2021
NPPES CertifiedJune 28, 2021
✔ NPI 1861062200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in AL · 1-126419
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
800 LAKESHORE DR, Birmingham, AL 35229
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.Insurance ›

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 Jill Formby 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 ID5294110573
PECOS Enrollment IDI20220922002803

Medicare Billing Reassignments

4

Medicare enrollment records show Amy Formby reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cullman Regional Anesthesia Services LLC
51 mi
Anesthesiology
1912 AL HWY 157
Cullman, AL 35058
  • Reassigned Medicare billing, Alabama enrollment
  • 55 clinicians in this Medicare group
NPI 1982163671 (256) 737-2639
Anesthesia Associates
58 mi
Anesthesiology
1521 RAINBOW DR
Gadsden, AL 35901
  • Reassigned Medicare billing, Alabama enrollment
  • 124 clinicians in this Medicare group
NPI 1821013905 (256) 546-5281
Fort Payne Anesthesia Services LLC
90 mi
Nurse Anesthetist, Certified Registered
200 MEDICAL CENTER DR SW
Fort Payne, AL 35968
  • Reassigned Medicare billing, Alabama enrollment
  • 22 clinicians in this Medicare group
NPI 1669263976 (660) 826-5960
Blue Lake Health Alabama, LLC
107 mi
Anesthesiology
103 HELTON CT
Florence, AL 35630
  • Reassigned Medicare billing, Alabama enrollment
  • 189 clinicians in this Medicare group
NPI 1376266726 (256) 760-0672

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

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.

SUSAN BRITTANY WILKES A.T.C., L.A.T.
Specialist/Technologist (Athletic Trainer)
800 LAKESHORE DR, ATHLETIC TRAINING DEPARTMENT
BIRMINGHAM, AL 35229
Jefferson County (205) 726-2574
LINDSEY ELMORE PHARMD
Pharmacist
800 LAKESHORE DR
BIRMINGHAM, AL 35229
Jefferson County (205) 726-4431
MR. CHRISTOPHER MICHAEL EVANS
Student in an Organized Health Care Education/Training Program
800 LAKESHORE DR
BIRMINGHAM, AL 35229
Jefferson County (205) 726-2011
MATTHEW R PRICE ATC
Specialist/Technologist (Athletic Trainer)
800 LAKESHORE DR
BIRMINGHAM, AL 35229
Jefferson County (205) 726-2805
ANNA GRACE TOWNER PA
Physician Assistant
800 LAKESHORE DR
BIRMINGHAM, AL 35229
Jefferson County (205) 726-2011
PETER HUGHES PHARM.D.
Pharmacist (Pharmacotherapy)
800 LAKESHORE DR
BIRMINGHAM, AL 35229
Jefferson County (205) 726-2519
DR. AMI TEAGUE SHELL PHARMD
Pharmacist
800 LAKESHORE DR, MCWHORTER SCHOOL OF PHARMACY
BIRMINGHAM, AL 35229
Jefferson County (205) 726-4367
MR. DEMETRIUS O'BRIAN GARNER
Student in an Organized Health Care Education/Training Program
800 LAKESHORE DR, MCWHORTER SCHOOL OF PHARMACY
BIRMINGHAM, AL 35229
Jefferson County (205) 726-2011

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 Formby's NPI number?

The NPI number for Amy Formby is 1861062200. It was assigned to this individual provider in the NPPES registry on June 28, 2021.

Where is Amy Formby located?

Amy Formby practices at 800 Lakeshore Dr, Birmingham, AL 35229. The listed phone number is (205) 726-2401.

What is Amy Formby's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Is Amy Formby enrolled in Medicare?

Yes. Amy Formby is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Amy Formby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amy Formby reassigns Medicare benefits to 4 organizations: Cullman Regional Anesthesia Services LLC (Cullman, AL), Anesthesia Associates (Gadsden, AL), Fort Payne Anesthesia Services LLC (Fort Payne, AL) and Blue Lake Health Alabama, LLC (Florence, AL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amy Formby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amy Formby accept?

Health plans from Blue Cross and Blue Shield of Alabama list Amy Formby as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amy Formby was last updated on June 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.