Individual provider Active NPI

Amy Lynn Wilds, LPN

  • Licensed Practical Nurse
  • Ironton, OH
National Provider Identifier
1396051041
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN115294 MEDS Issued in OH
Practice address
1339 Township Road 218
Ironton, OH 45638-8220
Phone
(740) 532-0067
Fax
(740) 532-1987
NPI assigned
Aug 19, 2010
Last updated
Aug 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN115294 MEDS OH Primary

Addresses

Primary practice location

1339 Township Road 218
Ironton, OH 45638-8220

Mailing address

1339 Township Road 218
Ironton, OH 45638-8220
Phone (740) 532-0067

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
PN115294 MEDSOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1396051041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 TOWNSHIP ROAD 218",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456388220",
            "telephone_number": "740-532-0067",
            "fax_number": "740-532-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 TOWNSHIP ROAD 218",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456388220",
            "telephone_number": "740-532-0067",
            "fax_number": "740-532-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDS",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN115294 MEDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ironton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.