Individual provider Active NPI

Amy Faye Thomas Bash, APN

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1063885937
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.011516 Issued in IL
Practice address
2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone
(773) 665-3200
Fax
(773) 665-0000
NPI assigned
Nov 2, 2015
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.011516 IL Primary

Addresses

Primary practice location

2900 N Lake Shore Dr
Chicago, IL 60657-5640

Mailing address

2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone (773) 665-3200

Other names 1

  • Amy Faye Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20161228002185 IL Practitioner - Nurse Practitioner 1456632777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.011516ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Sleep Medicine LLC CurrentSince May 22, 2022 Accepting new patients
Ucm Medical Group Sub, LLC Nurse Practitioner PastSince Jul 15, 2015 Accepting new patients

Locations

10640 165th St
Orland Park, IL 60467

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1063885937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3200",
            "fax_number": "773-665-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3200",
            "fax_number": "773-665-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS BASH",
        "first_name": "AMY",
        "middle_name": "FAYE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.011516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "THOMAS",
            "middle_name": "FAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.