Individual provider Active NPI

Amy Jo Zahn, N.P.

  • Nurse Practitioner
  • South Milwaukee, WI
National Provider Identifier
1467489575
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2912-003 Issued in WI
Practice address
902 Milwaukee Avenue
South Milwaukee, WI 53172-2118
Phone
(414) 764-4003
Fax
(414) 764-4005
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 126706 WI
Nurse Practitioner 363L00000X 2912-003 WI Primary

Addresses

Primary practice location

902 Milwaukee Avenue
South Milwaukee, WI 53172-2118

Mailing address

100 15TH Avenue
Suite 180
South Milwaukee, WI 53172-1160
Phone (414) 768-5430

Other names 1

  • Amy Jo Maerz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20061024000123 WI Practitioner - Nurse Practitioner 9234136813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
126706WIMDNurse Practitioner
2912-003WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince May 1, 2012 Accepting new patients
The Medical College of Wisconsin, Inc. Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1467489575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 15TH AVENUE",
            "address_2": "SUITE 180",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721160",
            "telephone_number": "414-768-5430",
            "fax_number": "414-762-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 MILWAUKEE AVENUE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722118",
            "telephone_number": "414-764-4003",
            "fax_number": "414-764-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAHN",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "126706",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2912-003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MAERZ",
            "middle_name": "JO",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.