Individual provider Active NPI

Amisha Hoosier

  • Licensed Practical Nurse
  • Maumee, OH
National Provider Identifier
1265903371
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.171049.MEDS Issued in OH
Practice address
1760 Manley Rd
Maumee, OH 43537-9400
Phone
(833) 641-0632
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703110550 MI
Licensed Practical Nurse 164W00000X LPN.171049.MEDS OH Primary

Addresses

Primary practice location

1760 Manley Rd
Maumee, OH 43537-9400

Mailing address

1760 Manley Rd
Maumee, OH 43537-9400
Phone (833) 641-0632

Other practice location 1

2521 N Elms Rd
Flushing, MI 48433-9423
Phone (810) 487-5521

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4703110550MIMDLicensed Practical Nurse
LPN.171049.MEDSOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1265903371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 MANLEY RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379400",
            "telephone_number": "833-641-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 MANLEY RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379400",
            "telephone_number": "833-641-0632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2521 N Elms Rd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "MI",
            "postal_code": "484339423",
            "country_code": "US",
            "telephone_number": "810-487-5521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOOSIER",
        "first_name": "AMISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703110550",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.171049.MEDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.