Individual provider Active NPI

Amy Lynn Constable, CRNP

  • Family Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1073288262
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP024198 Issued in PA
Practice address
680 Blair Mill Rd
Horsham, PA 19044-2223
Phone
(814) 540-6008
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 SP024198 PA Primary

Addresses

Primary practice location

680 Blair Mill Rd
Horsham, PA 19044-2223

Mailing address

680 Blair Mill Rd
Horsham, PA 19044-2223

Other identifiers 1

IdentifierTypeStateIssuer
15544063OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL amy_constable@optum.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251229002896 PA Order and Referring Only - Nurse Practitioner 1052798279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP024198PAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1073288262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "814-540-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTABLE",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15544063",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "amy_constable@optum.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "680 Blair Mill Rd",
            "city": "Horsham",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190442223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.