Individual provider Active NPI

Andrea Marie Pugh, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Akron, OH
National Provider Identifier
1063733970
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0036730 Issued in OH
Practice address
150 Cross Street
Akron, OH 44311-1026
Phone
(330) 996-9141
Fax
(330) 253-0377
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0036730 OH Primary
Licensed Practical Nurse 164W00000X PN103316 OH
Registered Nurse 163W00000X RN425615 OH

Addresses

Primary practice location

150 Cross Street
Akron, OH 44311-1026

Mailing address

150 Cross Street
Akron, OH 44311-1026
Phone (330) 996-9141

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
I20241120000521 OH Practitioner - Nurse Practitioner 9436437886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN425615OHMDRegistered Nurse
PN103316OHMDLicensed Practical Nurse
APRN.CNP.0036730OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Support Services, Inc Current Accepting new patients
Community Support Services, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Community Support Services Inc CurrentSince Oct 7, 2024 Accepting new patients

Locations

150 Cross St
Akron, OH 44311
Phone (330) 253-9388

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1063733970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CROSS STREET",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-996-9141",
            "fax_number": "330-253-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CROSS STREET",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-996-9141",
            "fax_number": "330-253-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0036730",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN103316",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN425615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.