Charles M Ammon
Individual provider Active NPI Family Nurse Practitioner · East Liverpool, OH
NPI 1306158944 · NPPES record last updated May 5, 2020
Key facts
- NPI
- 1306158944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.11984 (OH)
- Practice address
- 146 West 5TH Street
East Liverpool, OH 43920-3734 - Phone
- (330) 382-0165
- Fax
- (330) 382-0275
- NPI assigned
- Jul 12, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110425000067 | OH | Practitioner - Nurse Practitioner | 4284819913 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN270498 | OH | MD | Flight Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Physicians of Brooke County, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Flight Registered Nurse | 163WF0300X | RN270498 | OH | |
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.11984 | OH | Yes |
Addresses
Primary practice location
146 West 5TH Street
East Liverpool, OH 43920-3734
Mailing address
380 Summit Avenue Mso Physician Billing
Steubenville, OH 43952-2667
Phone (740) 283-7597
Other practice location 1
1800 Franklin St
Toronto, OH 43964-1949
Phone (740) 537-5087
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810023079 | Medicaid | WV | |
| 0060646 | Medicaid | OH |
Other providers in East Liverpool, OH
- Ruba Alhamid
- Scott Paul Alvey
- Always Best Care of Columbiana and Mahoning Counties
- Always Best Care of Columbiana and Mahoning Counties
- Jack C Amato
- Amy K. Lowery, D.O. LLC
- Christine Andujar
- Ankle and Foot Care Centers
- Ankle and Foot Care Centers
- Samantha Jeanne Apanasewicz
All providers in East Liverpool, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.