Individual provider Active NPI

Amber Lynn, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1063842813
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP5269 Issued in AZ
Practice address
2200 W Bethany Home Rd
Suite #2
Phoenix, AZ 85015-1997
Phone
(602) 710-1187
Fax
(602) 358-8551
NPI assigned
Nov 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP5269 AZ Primary

Addresses

Primary practice location

2200 W Bethany Home Rd
Suite #2
Phoenix, AZ 85015-1997

Mailing address

2200 W Bethany Home Rd
Suite #2
Phoenix, AZ 85015-1997
Phone (602) 317-2418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140204001341 AZ Practitioner - Nurse Practitioner 3274762729 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Innovations, Inc Current Accepting new patients
Jewish Family & Children'S Service CurrentSince Jul 25, 2016 Accepting new patients
Jewish Family & Children'S Service CurrentSince Jul 25, 2016 Accepting new patients
Recovery Innovations, Inc CurrentSince Apr 10, 2017 Accepting new patients
Recovery Innovations, Inc CurrentSince Apr 10, 2017 Accepting new patients
Southwest Behavioral Health Services, Inc. PastSince Dec 1, 2013 Accepting new patients
Living Hope Clinic LLC Past Accepting new patients

Locations

11361 N 99th Ave
Ste 107
Peoria, AZ 85345
Phone (602) 636-4605

11361 N 99th Ave
Ste 402
Peoria, AZ 85345
Phone (602) 636-4379

2701 N 16th St
Ste 316
Phoenix, AZ 85006

4747 N 7th St
Ste 100
Phoenix, AZ 85014
Phone (602) 279-7655

2033 N 7th St
Phoenix, AZ 85006
Phone (602) 257-9314

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1063842813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W BETHANY HOME RD",
            "address_2": "SUITE #2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151997",
            "telephone_number": "602-317-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W BETHANY HOME RD",
            "address_2": "SUITE #2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151997",
            "telephone_number": "602-710-1187",
            "fax_number": "602-358-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "AMBER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP5269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.