NPIMap

Individual provider Active NPI

Amber L Harriman, PA

  • Physician Assistant
  • Red Bud, IL
National Provider Identifier
1033307996
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003052 Issued in IL
Practice address
325 Spring Street
Red Bud, IL 62278
Phone
(618) 282-3831
Fax
(618) 282-5476
NPI assigned
Oct 4, 2007
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085003052 IL Primary

Addresses

Primary practice location

325 Spring Street
Red Bud, IL 62278

Mailing address

325 Spring St
Red Bud, IL 62278
Phone (618) 282-3831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000076 IL Practitioner - Physician Assistant 6204924368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Bud Illinois Hospital Company LLCGroup PAC ID 2466416821, 15 clinicians

Practice addresses (Care Compare)

325 Spring St
Red Bud, IL 62278-1105

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Red Bud Regional Hospital Inc CurrentSince Jan 14, 2023 Accepting new patients
DRS Pichet & Meechai Past Accepting new patients
Family Practice Associates, PC Past Accepting new patients
Red Bud Illinois Hospital Company LLC Past Accepting new patients

Locations

325 Spring St
Redbud, IL 62278
Phone (618) 282-5165

Interoperability endpoints

  • Direct secure messaging: aharrima@yourcarecommunity.org
  • Direct secure messaging: amber.harriman.1@27782.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1033307996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SPRING ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "62278",
            "telephone_number": "618-282-3831",
            "fax_number": "618-282-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SPRING STREET",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "62278",
            "telephone_number": "618-282-3831",
            "fax_number": "618-282-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIMAN",
        "first_name": "AMBER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bud, IL

Sources for this page

Verify at the official NPI Registry.