Amber Champ, NP
Individual provider Active NPI Family Nurse Practitioner · Greenville, OH
NPI 1053047985 · NPPES record last updated Jul 25, 2024
Key facts
- NPI
- 1053047985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.0031633 (OH)
- Practice address
- 5735 Meeker Rd
Greenville, OH 45331-1180 - Phone
- (937) 548-9680
- NPI assigned
- Jul 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Iu Health Medical Group LLC
Indiana University Health Ball Memorial Physicians Inc
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 747-3111
Hospital & facility affiliations
- Indiana University Health Ball Memorial Hospital
- Indiana University Health Jay, Inc.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220810002218 | OH | Practitioner - Nurse Practitioner | 3779966627 | Reassigns benefits to 1 organization |
| I20240802001281 | IN | Practitioner - Nurse Practitioner | 3779966627 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71015465A | IN | MD | Family Nurse Practitioner |
| APRN.CNP.0031633 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Family | Current |
Accepting new patients |
| Family Health Services of Darke County, Inc. | Current |
Accepting new patients | |
| Family Health Services of Darke County Inc | Current | Accepting new patients | |
| Family Health Services of Darke County, Inc. | Current |
Accepting new patients | |
| Indiana University Health Ball Memorial Physicians, Inc. | Current |
Accepting new patients | |
| Indiana University Health Ball Memorial Physicians, Inc. | Past | Accepting new patients |
Locations
3832 Solutions Ctr
Chicago, IL 60677
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141
2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111
2200 Forest Ridge Pkwy
Ste 120
New Castle, IN 47362
Phone (765) 593-2960
510 W Votaw St
Portland, IN 47371
Phone (260) 726-2890
702 N Main St
Arcanum, OH 45304
Phone (937) 548-1141
1101 Jackson St
Ste C
Greenville, OH 45331
Phone (937) 547-2319
5735 Meeker Rd
Greenville, OH 45331
Phone (937) 548-3806
10484 Kley Rd
Versailles, OH 45380
Phone (937) 526-3016
Interoperability endpoints
- achamp@direct.iuhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71015465A | IN | |
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0031633 | OH | Yes |
Addresses
Primary practice location
5735 Meeker Rd
Greenville, OH 45331-1180
Mailing address
5735 Meeker Rd
Greenville, OH 45331-1180
Phone (937) 548-9680
Other practice location 1
2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 281-2030
Other names
- Amber A Keller
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | achamp@direct.iuhealth.org | Direct |
Other providers in Greenville, OH
- Morgan Carter
- Douglas Charles Caserta
- Cleanne Cass
- Belinda Jean Chaffins
- Chane Chalou
- Cherry Fourman DDS Inc
- CHN Inc. Adult Day Care
- CHN LLC Adult Day Care
- Henry H. Chong
- Kristene Kae Clark
All providers in Greenville, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.