Individual provider Active NPI

Amanda R Kruse, CNP

  • Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1174870877
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.13639 Issued in OH
Practice address
7634 W Central Ave
Toledo, OH 43617-1526
Phone
(567) 585-0460
Fax
(567) 585-0461
NPI assigned
Aug 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.13639 OH Primary
Family Nurse Practitioner 363LF0000X COA.13639 OH

Addresses

Primary practice location

7634 W Central Ave
Toledo, OH 43617-1526

Mailing address

7634 W Central Ave
Toledo, OH 43617-1526

Other practice location 1

4235 Secor Rd
Toledo, OH 43623-4231
Phone (419) 479-5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20131114001296 OH Practitioner - Nurse Practitioner 3870729163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.13639OHMDNurse Practitioner
COA.13639OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Jul 26, 2022 Accepting new patients
Promedica Central Physicians Nurse Practitioner CurrentSince Jul 26, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5705 Monclova Rd
Maumee, OH 43537
Phone (419) 893-3321

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

7634 W Central Ave
Toledo, OH 43617
Phone (419) 841-2303

100 Madison Ave
#38805
Toledo, OH 43604
Phone (567) 585-1964

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1174870877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7634 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7634 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171526",
            "telephone_number": "567-585-0460",
            "fax_number": "567-585-0461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4235 Secor Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436234231",
            "country_code": "US",
            "telephone_number": "419-479-5893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "AMANDA",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.13639",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.13639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.