Individual provider Active NPI

Amy M Cullen, APRN

  • Family Nurse Practitioner
  • Londonderry, NH
National Provider Identifier
1083031389
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
058450-23 Issued in NH
Practice address
50 Nashua Rd Ste 301
Londonderry, NH 03053-3444
Phone
(603) 425-6494
Fax
(603) 425-2048
NPI assigned
Mar 25, 2014
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 058450-23 NH Primary
Family Nurse Practitioner 363LF0000X 05845023 NH

Addresses

Primary practice location

50 Nashua Rd Ste 301
Londonderry, NH 03053-3444

Mailing address

50 Nashua Rd Ste 301
Londonderry, NH 03053-3444
Phone (603) 425-6494

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://mycw44.eclinicalweb.com/portal4967/jsp/100mp/login_otp.jsp Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20161027001549 NH Practitioner - Nurse Practitioner 7315225208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Landmark Family HealthcareGroup PAC ID 8729012661, 4 clinicians

Practice addresses (Care Compare)

50 Nashua Rd
Suite 301
Londonderry, NH 03053-3444
Phone (603) 425-6494

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05845023NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Landmark Family Healthcare Family CurrentSince May 24, 2022 Accepting new patients
Landmark Family Healthcare PastSince May 24, 2022 Accepting new patients

Locations

50 Nashua Rd
Ste 301
Londonderry, NH 03053
Phone (603) 425-6494

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FHBAAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FHBAAA/Endpoint/FHBAAA

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1083031389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 NASHUA RD STE 301",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533444",
            "telephone_number": "603-425-6494",
            "fax_number": "603-425-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NASHUA RD STE 301",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533444",
            "telephone_number": "603-425-6494",
            "fax_number": "603-425-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "058450-23",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "05845023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://mycw44.eclinicalweb.com/portal4967/jsp/100mp/login_otp.jsp",
            "affiliation": "N",
            "endpointDescription": "Portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 Nashua Rd Ste 301",
            "city": "Londonderry",
            "state": "NH",
            "country_code": "US",
            "postal_code": "030533444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Londonderry, NH

Sources for this page

Verify at the official NPI Registry.