Individual provider Active NPI

Amy Jo Schwab, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1013493345
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5967 Issued in MN
Practice address
332 W Superior St Ste 300
Duluth, MN 55802-1844
Phone
(218) 722-4379
Fax
(218) 722-4333
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5967 MN Primary

Addresses

Primary practice location

332 W Superior St Ste 300
Duluth, MN 55802-1844

Mailing address

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-4710

Other practice location 1

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-4710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180911000233 MN Practitioner - Nurse Practitioner 1850641978 Reassigns benefits to 1 organization
I20231103000779 WI Practitioner - Nurse Practitioner 1850641978 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
5967MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Sep 6, 2023 Accepting new patients
Nystrom & Associates, LTD CurrentSince Dec 2, 2019 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Sep 6, 2023 Accepting new patients

Locations

332 W Superior St
Ste 300
Duluth, MN 55802
Phone (218) 481-9408

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

2501 Hanley Rd
Ste 201
Hudson, WI 54016
Phone (534) 544-5247

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1013493345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015114",
            "telephone_number": "218-333-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 W SUPERIOR ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021844",
            "telephone_number": "218-722-4379",
            "fax_number": "218-722-4333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 Anne St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566015114",
            "country_code": "US",
            "telephone_number": "218-333-4710",
            "fax_number": "218-333-2640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWAB",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "5967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.