Amy Cavanaugh, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

14309-33 Issued in WI

Practice address

825 Walton Dr
Plymouth, WI 53073-5022

Phone

(920) 892-4322

NPI assigned

Aug 23, 2023

Last updated

Jan 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amy Paulus Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Prevea Clinic, Inc.

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1306869276

  Single Specialty

  Medicare reassignment NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • General Practice Physician
  • Green Bay, WI
  • NPI 1285613638

  Single Specialty

  Medicare reassignment NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba Prevea Sheboygan Health Center

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1275799413

  Single Specialty

  Medicare reassignment NPD
• Prevea Clinic, Inc.

  • Family Medicine Physician
  • Chippewa Falls, WI
  • NPI 1588110969
  NPD
• St Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St. Nicholas Hospital

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1447737762

  Single Specialty

  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • Durable Medical Equipment & Medical Supplies
  • Green Bay, WI
  • NPI 1245042530

  Single Specialty

  NPD

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1477337061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WALTON DR",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530735022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WALTON DR",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530735022",
            "telephone_number": "920-892-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "AMY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14309-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252605",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acavanaugh407155@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "825 Walton Dr",
            "city": "Plymouth",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530735022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "PAULUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon L Bush, D.C.
• Heidi Ann Butler, MSW, LCSW, CSAC
• Megan M Butler, MD
• Calming Waters Family Counseling
• Stephani Joy Casarez
• Jan W Cecka, D.C
• Chiro-Health Chiropractic Care Center LLC
• City of Plymouth (Plymouth Fire Department Ambulance Squad)
• County of Sheboygan (Rocky Knoll Health Care Center)
• April L Decker, PT

• Family Nurse Practitioner in Plymouth, WI
• Providers in Plymouth, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.