Active NPI
Amy Lynn Wadsworth, FNP
- Family Nurse Practitioner
- Brooklyn, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704307540
- Practice address
- 212 S Main St Ste a
Brooklyn, MI 49230-9114 - Phone
- (517) 938-6085
- Fax
- (517) 938-6086
- NPI assigned
- Nov 6, 2020
- Last updated
- Feb 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704307540 | MI | Primary |
Addresses
Primary practice location
212 S Main St Ste a
Brooklyn, MI 49230-9114
Mailing address
24 Frank Lloyd Wright Dr # J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766
Other practice location 1
45300 Cherry Hill Rd # 8190
Canton, MI 48187-5073
Phone (734) 981-3968
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4704307540 | Other | MI | MI LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Michigan Medical School, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1255 E M
Pinckney, MI 48169-8133
Phone (734) 878-1000
128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677
14288 E Old US Hwy 12
Chelsea, MI 48118-2700
202 W Highland Rd
Howell, MI 48843-1162
212 S Main St
Brooklyn, MI 49230-9114
2305 Genoa Bus Park Dr
Brighton, MI 48114-7005
44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700
5505 S Old US
Brighton, MI 48116-7524
5505 S Old US 23
101 Thimg Lifestyle Medicine Primary Care E
Brighton, MI 48116-7524
Phone (734) 887-7888
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Services Corporation | Current | Accepting new patients | |
| Iha Health Service Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients |
Locations
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400
2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840
212 S Main St
Ste A
Brooklyn, MI 49230
Phone (517) 592-8033
49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
Interoperability endpoints
- awadsworth3204025@direct.trinity-health.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba IHA Canton Obstetrics and Gynecology
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
dba Trinity Health IHA Medical Group OB/GYN Float
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
dba IHA Urgent Care-Domino's Farms
- Urgent Care Clinic/Center
- Ann Arbor, MI
- NPI 1992937023
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Trinity Heath Ann Arbor Hospital
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1063013837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DR # J2000",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484",
"telephone_number": "734-747-6766",
"fax_number": "734-222-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 S MAIN ST STE A",
"city": "BROOKLYN",
"state": "MI",
"postal_code": "492309114",
"telephone_number": "517-938-6085",
"fax_number": "517-938-6086"
}
],
"practiceLocations": [
{
"address_1": "45300 Cherry Hill Rd # 8190",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "MI",
"postal_code": "481875073",
"country_code": "US",
"telephone_number": "734-981-3968",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WADSWORTH",
"first_name": "AMY",
"middle_name": "LYNN",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-06",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704307540",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI LICENSE",
"identifier": "4704307540",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, MI
- Sally Rae-Reinink Vermilya, MA CCC-SLP
- Claudia Villarreal Carrillo, M.D.
- Courtney Villarreal, LLPC
- Jesse Charles Vivian, RPH
- W. a. Foote Memorial Hospital, Inc (Henry Ford Allegiance Health)
- Shane Edward Wallace, DC
- Kathleen Walworth, DPT
- Eric Wandschneider, MD
- Hillary Watson
- Weatherwax Family Pharmacies Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.