Individual provider Active NPI

Amanda Denise La Favers

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
National Provider Identifier
1205460813
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
019993 Issued in OH
Practice address
10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone
(513) 865-1111
NPI assigned
Feb 24, 2020
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 019993 OH Primary

Addresses

Primary practice location

10500 Montgomery Rd
Cincinnati, OH 45242-4402

Mailing address

1720 Red Clover Dr
Lebanon, OH 45036-4094
Phone (270) 585-3854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210311002673 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739518176 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Anesthesia, PSCGroup PAC ID 5092627521, 181 clinicians
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (270) 538-7058

1801 Ashley Cir
Bowling Green, KY 42104-3362
Phone (270) 793-1000

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 781-7178

310 S Limestone
Lexington, KY 40508-3008
Phone (859) 252-6612

913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-1212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019993OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Ad of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2025 Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2023 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc CurrentSince Jan 4, 2021 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients

Locations

1801 Ashley Cir
Ste 100
Bowling Green, KY 42104

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

484 Golden Autumn Way
Ste 100
Bowling Green, KY 42103
Phone (270) 793-1000

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

225 Abraham Flexner Way
Ste 700
Louisville, KY 40202
Phone (502) 562-0398

1000 Breckenridge St
Ste 100
Owensboro, KY 42303
Phone (270) 683-2751

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

Organizations & group practices 7

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 2

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1205460813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 RED CLOVER DR",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450364094",
            "telephone_number": "270-585-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452424402",
            "telephone_number": "513-865-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA FAVERS",
        "first_name": "AMANDA",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "019993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.