Promise Amhanzenodion, NP
Individual provider Active NPI Family Nurse Practitioner · Reading, PA
NPI 1487237137 · NPPES record last updated Apr 22, 2022
Key facts
- NPI
- 1487237137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP023324 (PA)
- Practice address
- 555 Raymond St Ste 100
Reading, PA 19605-3101 - Phone
- (610) 921-1111
- NPI assigned
- Apr 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220516001076 | PA | Practitioner - Nurse Practitioner | 9830576743 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Medical Group P C | Single Specialty | Current |
Accepting new patients |
| Integrated Medical Group, P.C. | Current |
Accepting new patients | |
| Commonwealth Primary Care, PC | Single Specialty | Past |
Accepting new patients |
Locations
82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455
48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555
420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000
555 Raymond St
Reading, PA 19605
Phone (610) 921-1111
6 Hearthstone Ct
Ste 201
Reading, PA 19606
Phone (610) 779-9550
555 Raymond St
Ste 100
Reading, PA 19605
Phone (610) 921-1111
Interoperability endpoints
- pamhanzenodion@imgpc.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Family Nurse Practitioner |
363LF0000X | SP023324 | PA | Yes |
Addresses
Primary practice location
555 Raymond St Ste 100
Reading, PA 19605-3101
Mailing address
14 Courtney Rea Cir
Reading, PA 19606-3072
Other practice location 1
6 Hearthstone Ct Ste 201
Reading, PA 19606-3066
Phone (610) 779-9550
Other providers in Reading, PA
- America'S Best Contact & Eyeglasses
- American Current Care P.a .
- American Current Care P.a.
- American Current Care PA PC
- American Family Dental Care P.C
- Darshita Amin
- Priya Amin
- Elise Rachel Amon
- Einar Andersen
- Kalia Anderson
All providers in Reading, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.