Individual provider Active NPI

Amberly Brewer, MD

  • Pediatrics Physician
  • Crown Point, IN
National Provider Identifier
1255311544
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01061157 Issued in IN
Practice address
1505 S Court St
Suite 101
Crown Point, IN 46307-4809
Phone
(219) 757-6495
Fax
(219) 757-6481
NPI assigned
Jan 20, 2006
Last updated
May 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01061157 IN Primary

Addresses

Primary practice location

1505 S Court St
Suite 101
Crown Point, IN 46307-4809

Mailing address

1040 Sierra Dr
Suite 400
Greenwood, IN 46143-7241
Phone (317) 528-4284

Other identifiers 2

IdentifierTypeStateIssuer
200532310MedicaidIN
000000721907OtherINANTHEM TRADITIONAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Health Crown Point Past Accepting new patients
St Anthony Medical Center Past Accepting new patients
Associated Pediatricians, LLC Pediatrics Past Accepting new patients
Associated Pediatricians, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1255311544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SIERRA DR",
            "address_2": "SUITE 400",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437241",
            "telephone_number": "317-528-4284",
            "fax_number": "317-865-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S COURT ST",
            "address_2": "SUITE 101",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074809",
            "telephone_number": "219-757-6495",
            "fax_number": "219-757-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "AMBERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01061157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200532310",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM TRADITIONAL",
            "identifier": "000000721907",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.