Individual provider Active NPI

Mary Amber Ervin, PA-C

  • Physician Assistant
  • New Albany, IN
National Provider Identifier
1255660528
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004673B Issued in IN
Practice address
1850 State St
New Albany, IN 47150-4990
Phone
(502) 724-8135
NPI assigned
Dec 16, 2009
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004673B IN Primary
Occupational Therapist 225X00000X R4333 KY

Addresses

Primary practice location

1850 State St
New Albany, IN 47150-4990

Mailing address

PO Box 185
Floyds Knobs, IN 47119-0185

Other names 1

  • Mary Amber Ervin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250108001630 IN Practitioner - Physician Assistant 3375071137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R4333KYMDOccupational Therapist
10004673BINMDPhysician Assistant

Organizations & group practices 1

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": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1255660528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471190185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 STATE ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504990",
            "telephone_number": "502-724-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "MARY",
        "middle_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004673B",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R4333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ERVIN",
            "middle_name": "AMBER",
            "credential": "OTR/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.