NPIMap

Individual provider Active NPI

Amie Lynn Fannin, APRN

  • Family Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1467635391
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016180 Issued in KY
Practice address
613 23Rd St Ste 430
Ashland, KY 41101-2885
Phone
(606) 408-8200
Fax
(606) 408-6291
NPI assigned
Dec 13, 2007
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3016180 KY Primary

Addresses

Primary practice location

613 23Rd St Ste 430
Ashland, KY 41101-2885

Mailing address

247 Beacon Hill Rd
Morehead, KY 40351-6030
Phone (606) 784-1115

Other practice location 1

307 Rebecca Lynn Dr
Rush, KY 41168-8100
Phone (606) 923-8951

Other names 1

  • Amie Shavers Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105000386 KY Practitioner - Nurse Practitioner 8921499757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

617 23Rd St
Suite 400
Ashland, KY 41101-2880
Phone (606) 329-1770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
W. Michael Spurlock, D.C., P.S.C. CurrentSince Oct 1, 2021 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Nov 13, 2023 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Nov 13, 2023 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

613 23rd St
Ste 430
Ashland, KY 41101
Phone (606) 408-8200

617 23rd St
Ste 400
Ashland, KY 41101
Phone (606) 329-1770

247 Beacon Hill Rd
Morehead, KY 40351
Phone (606) 784-1115

Interoperability endpoints

  • Direct secure messaging: ashavers56746@direct.kdhealth.us

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1467635391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 BEACON HILL RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403516030",
            "telephone_number": "606-784-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST STE 430",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012885",
            "telephone_number": "606-408-8200",
            "fax_number": "606-408-6291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Rebecca Lynn Dr",
            "address_purpose": "LOCATION",
            "city": "Rush",
            "state": "KY",
            "postal_code": "411688100",
            "country_code": "US",
            "telephone_number": "606-923-8951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANNIN",
        "first_name": "AMIE",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMIE",
            "last_name": "SHAVERS",
            "credential": "APRN/NURSE PRACTITIO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.