Provider Demographics
NPI:1912911017
Name:AMOS, ANKIE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANKIE
Middle Name:MARIE
Last Name:AMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2762
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:303-398-1211
Practice Address - Street 1:1400 JACKSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:303-388-4461
Practice Address - Fax:303-270-2206
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5939207RC0000X
AK4000207RC0000X
NC2002-00229207RC0000X
CO62523207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904464Medicaid
AK1012250Medicaid
CO1912911017Medicaid
AK1012250Medicaid
NC5904464Medicaid