Active NPI
Amy Hermus, PA-C
- Medical Physician Assistant
- Oregon, WI
National Provider Identifier
1356717904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 460-23
- Practice address
- 451 Butternut Dr
Oregon, WI 53575-1349 - Phone
- (608) 835-8929
- NPI assigned
- Aug 18, 2015
- Last updated
- Aug 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 460-23 | WI | Primary |
Addresses
Primary practice location
451 Butternut Dr
Oregon, WI 53575-1349
Mailing address
451 Butternut Dr
Oregon, WI 53575-1349
Phone (608) 835-8929
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
| License | State | Type | Specialty |
|---|---|---|---|
| 460-23 | WI | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439856000000",
"number": "1356717904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 BUTTERNUT DR",
"city": "OREGON",
"state": "WI",
"postal_code": "535751349",
"telephone_number": "608-835-8929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 BUTTERNUT DR",
"city": "OREGON",
"state": "WI",
"postal_code": "535751349",
"telephone_number": "608-835-8929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMUS",
"first_name": "AMY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-18",
"last_updated": "2015-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "460-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oregon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.