Individual provider Active NPI

Amanda Nicole Gengler, NP-C

  • Nurse Practitioner
  • New Lebanon, OH
National Provider Identifier
1093525529
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0038361 Issued in OH
Practice address
442 Holderman PL
New Lebanon, OH 45345-1514
Phone
(937) 974-7089
NPI assigned
Jan 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 APRN.CNP.0038361 OH Primary

Addresses

Primary practice location

442 Holderman PL
New Lebanon, OH 45345-1514

Mailing address

442 Holderman PL
New Lebanon, OH 45345-1514
Phone (937) 974-7089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0038361OHMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1093525529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 HOLDERMAN PL",
            "city": "NEW LEBANON",
            "state": "OH",
            "postal_code": "453451514",
            "telephone_number": "937-974-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 HOLDERMAN PL",
            "city": "NEW LEBANON",
            "state": "OH",
            "postal_code": "453451514",
            "telephone_number": "937-974-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENGLER",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0038361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lebanon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.