Individual provider Active NPI

Amy Renae Philipps, FNP-C

  • Family Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1063910750
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007793A Issued in IN
Practice address
2272 N Main St
Crown Point, IN 46307-1802
Phone
(219) 661-5601
NPI assigned
Jan 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71007793A IN Primary

Addresses

Primary practice location

2272 N Main St
Crown Point, IN 46307-1802

Mailing address

15341 Montgomery St
Hebron, IN 46341-9022
Phone (219) 741-2629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180228002134 IN Practitioner - Nurse Practitioner 9830450170 Reassigns benefits to 1 organization
I20260410002594 KY Practitioner - Nurse Practitioner 9830450170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostics of Indiana LLCGroup PAC ID 3072548502, 121 clinicians

Practice addresses (Care Compare)

2272 N Main St
Crown Point, IN 46307-1802
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71007793AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostics of Indiana, LLC Family CurrentSince Feb 20, 2018 Accepting new patients

Locations

2272 N Main St
Crown Point, IN 46307
Phone (219) 286-4518

9805 Geist Crossing Dr
Indianapolis, IN 46256
Phone (317) 577-1353

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1063910750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15341 MONTGOMERY ST",
            "city": "HEBRON",
            "state": "IN",
            "postal_code": "463419022",
            "telephone_number": "219-741-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2272 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071802",
            "telephone_number": "219-661-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPPS",
        "first_name": "AMY",
        "middle_name": "RENAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-27",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007793A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.