Abena F Amponsah, FNP-BC
Individual provider Active NPI Nurse Practitioner · Saint Joseph, MI
NPI 1114529484 · NPPES record last updated Aug 18, 2021
Key facts
- NPI
- 1114529484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704245134 (MI)
- Practice address
- 4025 Health Park LN
Saint Joseph, MI 49085-3421 - Phone
- (269) 429-7100
- Fax
- (269) 429-1307
- NPI assigned
- Nov 12, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integrated Rehab Consultants LLC
Practice addresses (Care Compare)
1101 E Coolspring Ave
Michigan City, IN 46360-6310
Phone (219) 874-5211
3905 Lorraine Path
Saint Joseph, MI 49085-8630
Phone (269) 428-1111
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210203000232 | MI | Practitioner - Nurse Practitioner | 9335553304 | Reassigns benefits to 2 organizations |
| I20221103000723 | IN | Practitioner - Nurse Practitioner | 9335553304 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704245134 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospice at Home, Inc. | Current |
Accepting new patients | |
| Integrated Rehab Consultants LLC | Current |
Accepting new patients | |
| Integrated Rehab Consultants LLC | Current |
Accepting new patients |
Locations
1260 City Center Dr
Carmel, IN 46032
Phone (463) 333-9110
950 Park East Blvd
Lafayette, IN 47905
Phone (765) 237-5613
1101 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 874-5211
2400 Silhavy Rd
Valparaiso, IN 46383
Phone (219) 462-1778
1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222
3905 Lorraine Path
Saint Joseph, MI 49085
Phone (248) 428-1111
4025 Health Park Ln
Saint Joseph, MI 49085
Phone (269) 429-7100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704245134 | MI | Yes |
Addresses
Primary practice location
4025 Health Park LN
Saint Joseph, MI 49085-3421
Mailing address
4025 Health Park LN
Saint Joseph, MI 49085-3421
Phone (269) 429-7100
Other providers in Saint Joseph, MI
- Robert M Allen
- Amedisys Michigan LLC
- American Limb & Orthopedic Co.
- Amelia Elizabeth Ames
- Ann Marie Amicarelli-Cruz
- Catherine Anastas
- Kelsey Andershock
- Jordan Anderson
- Julia Heen Anderson
- Mary Lou Anderson
All providers in Saint Joseph, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.