Individual provider Active NPI

Amy Brewer

  • Family Nurse Practitioner
  • Dry Prong, LA
National Provider Identifier
1124758081
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
225791 Issued in LA
Practice address
800 Grove St
Dry Prong, LA 71423-4379
Phone
(318) 569-8298
NPI assigned
Jun 14, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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 225791 LA Primary

Addresses

Primary practice location

800 Grove St
Dry Prong, LA 71423-4379

Mailing address

PO Box 37
Montgomery, LA 71454-0037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20221107000085 LA Practitioner - Nurse Practitioner 9830566710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CLHG-Winn, LLCGroup PAC ID 6002198736, 17 clinicians

Practice addresses (Care Compare)

301 W Boundary Ave
Winn Parish Medical Center Physica
Winnfield, LA 71483-3427
Phone (318) 648-3000

301 W Boundary Ave B
Winn Wellness Clinic
Winnfield, LA 71483-3427
Phone (318) 209-4646

639 W Lafayette St
Winn Rural Health
Winnfield, LA 71483-3451
Phone (318) 648-3025

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225791LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Winn LLC CurrentSince Jul 30, 2024 Accepting new patients
CLHG-Winn, LLC Current Accepting new patients
BJC Healthcare, LLC PastSince Jun 21, 2022 Accepting new patients

Locations

301 W Boundary Ave
Winnfield, LA 71483
Phone (318) 628-2721

301 W Boundary Ave
Ste B
Winnfield, LA 71483
Phone (318) 209-4646

639 W Lafayette St
Winnfield, LA 71483
Phone (318) 648-2220

Interoperability endpoints

  • Direct secure messaging: amy.brewer.1@25133.direct.athenahealth.com

Organizations & group practices 3

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1124758081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "MONTGOMERY",
            "state": "LA",
            "postal_code": "714540037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GROVE ST",
            "city": "DRY PRONG",
            "state": "LA",
            "postal_code": "714234379",
            "telephone_number": "318-569-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "225791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dry Prong, LA

Sources for this page

Verify at the official NPI Registry.