NPIMap

Individual provider Active NPI

Amanda Jo Overmyer, M.D.

  • Family Medicine Physician
  • Ludington, MI
National Provider Identifier
1104011394
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301090734 Issued in MI
Practice address
7 Atkinson Dr Ste 111
Ludington, MI 49431-1917
Phone
(231) 843-3487
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301090734 MI Primary

Addresses

Primary practice location

7 Atkinson Dr Ste 111
Ludington, MI 49431-1917

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other names 1

  • Amanda Jo Kusebuski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000798 MI Practitioner - Family Practice 3375669138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical Center of West MichiganGroup PAC ID 3678543659, 62 clinicians

Practice addresses (Care Compare)

1 Atkinson Dr
Ludington, MI 49431-1906
Phone (231) 843-2591

7 Atkinson Dr
Ludington, MI 49431-1953

922 Lawndale St
Ludington, MI 49431-1928
Phone (231) 845-7380

Hospital & facility affiliations

  • Corewell Health Visiting Nurse Association Home health agency, Grand Rapids, MI, CCN 237007
  • Northern Home Care, Inc Home health agency, Pentwater, MI, CCN 237243
  • Elara Caring Home health agency, Ludington, MI, CCN 239308
  • Harbor Hospice Hospice, Muskegon, MI, CCN 231508
  • Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Memorial Medical Center of West Michigan Family Medicine CurrentSince May 3, 2015 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Feb 1, 2014 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Feb 1, 2014 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince May 3, 2015 Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

2481 N 72nd Ave
Hart, MI 49420
Phone (231) 873-2163

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

7 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2664

7 Atkinson Dr
Ste 111
Ludington, MI 49431
Phone (231) 733-2008

922 Lawndale St
Ludington, MI 49431
Phone (231) 845-7380

Interoperability endpoints

  • Direct secure messaging: aovermyer7080@epic00.corewelldirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1104011394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ATKINSON DR STE 111",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311917",
            "telephone_number": "231-843-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERMYER",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301090734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KUSEBUSKI",
            "middle_name": "JO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.