Jane A Broering Ammons, MD,
Individual provider Active NPI Psychiatry Physician · Maumee, OH
NPI 1164596961 · NPPES record last updated Aug 20, 2015
Key facts
- NPI
- 1164596961
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 34064493 (OH)
- Practice address
- 1627 Henthorne Dr
Suite B
Maumee, OH 43537-1370 - Phone
- (419) 866-8232
- Fax
- (419) 866-8233
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Medical College of Ohio, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1627 Henthorne Dr
Suite B
Maumee, OH 43537-1370
1627 Henthorne Dr B
Maumee, OH 43537-1370
Phone (419) 866-8232
Hospital & facility affiliations
- Promedica Toledo Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080131000152 | OH | Practitioner - Psychiatry | 3870675770 |
Receives reassigned benefits from 3 practitioners Practice locations: Maumee, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34064493 | OH | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jane Broering Ammons | Psychiatry | Past |
Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 34064493 | OH | Yes |
Addresses
Primary practice location
1627 Henthorne Dr
Suite B
Maumee, OH 43537-1370
Mailing address
1627 Henthorne Dr
Suite B
Maumee, OH 43537-1370
Phone (419) 866-8232
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0163255 | Medicaid | OH |
Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2015. 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.