Amy Jo Dupuis, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61490625 Issued in WA

Practice address

273 Sussex Ave E
Tenino, WA 98589-9359

Phone

(360) 264-5665

Fax

(360) 264-5666

NPI assigned

Sep 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Choice DermatologyGroup PAC ID 4789005034, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Clear Choice Dermatology

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1891327185

  WA

  Medicare reassignment Care Compare group NPD
• Lewis County Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Chehalis, WA
  • NPI 1134164692
  Medicare reassignment NPD
• Lewis County Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Raymond, WA
  • NPI 1205196540
  NPD
• Lewis County Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Centralia, WA
  • NPI 1811669658
  NPD

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1295511913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 SUSSEX AVE E",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985899359",
            "telephone_number": "360-264-5665",
            "fax_number": "360-264-5666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2690 NE Kresky Ave",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985322412",
            "country_code": "US",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUPUIS",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61490625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2265652",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tianne Carolyn Carrigan, LMP
• Daniel Ray Coleman, P.T.
• Ronald H Coulson, D.C.
• Daniel R. Coleman
• Samantha Davis, LCSW 43737
• Brad E. Ellisor, DC
• Gay M Jensen, RDH, PLLC
• Brian Ray Hedden, RPH
• Heddens Pharmacy Inc
• Heddens Pharmacy Inc

• Family Nurse Practitioner in Tenino, WA
• Providers in Tenino, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.