Individual provider Active NPI

Amy M. King, NP

  • Adult Health Nurse Practitioner
  • Elyria, OH
National Provider Identifier
1043251663
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP-08416 Issued in OH
Practice address
630 E River St
Elyria, OH 44035-5902
Phone
(440) 329-7500
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP-08416 OH Primary

Addresses

Primary practice location

630 E River St
Elyria, OH 44035-5902

Mailing address

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Other identifiers 2

IdentifierTypeStateIssuer
P00663386OtherMEDICARE RAILROAD
2675574MedicaidOH

Other names 1

  • Amy M. Hahner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061107000242 OH Practitioner - Nurse Practitioner 1658378518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-08416OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emh Regional Medical Center CurrentSince Oct 1, 2006 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2021 Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2021 Accepting new patients
Emh Regional Medical Center CurrentSince Oct 1, 2006 Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

125 E Broad St
Ste 305
Elyria, OH 44035
Phone (440) 326-4120

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: aking28124@ehrdirect.uhhospitals.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1043251663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "AMY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP-08416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00663386",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2675574",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HAHNER",
            "middle_name": "M.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.