Individual provider Active NPI

Amy Marie Livingston, ANP

  • Adult Health Nurse Practitioner
  • Willoughby, OH
National Provider Identifier
1497056642
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11970-NP Issued in OH
Practice address
4176 State Route 306
Willoughby, OH 44094-9203
Phone
(440) 918-4690
Fax
(440) 918-4694
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11970-NP OH Primary

Addresses

Primary practice location

4176 State Route 306
Willoughby, OH 44094-9203

Mailing address

PO Box 781389
Detroit, MI 48278-1389
Phone (440) 918-4690

Other identifiers 2

IdentifierTypeStateIssuer
3103171MedicaidOH
RN 325805OtherOHCERTIFICATE OF AUTHORITY

Other names 1

  • Amy M Neczypor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20101209000697 OH Practitioner - Nurse Practitioner 0941497424 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of OhioGroup PAC ID 3375924301, 51 clinicians
Preferred Physician Services of Ohio LLCGroup PAC ID 7315328069, 66 clinicians

Practice addresses (Care Compare)

3239 Jefferson Ave
Suite 1
Cincinnati, OH 45220-2270
Phone 99799192769276

9200 Worthington Rd
Suite 300
Westerville, OH 43082-7240
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System Inc CurrentSince Sep 15, 2015 Accepting new patients
Curana Health of Ohio CurrentSince Nov 2, 2022 Accepting new patients
Lake Hospital System Inc Nurse Practitioner Current Accepting new patients
Ohio Living Palliative Care Greater Toledo LLC CurrentSince Mar 8, 2021 Accepting new patients
Preferred Physician Services of Ohio LLC CurrentSince Mar 1, 2023 Accepting new patients
Lake Hospital System, Inc CurrentSince Sep 15, 2015 Accepting new patients

Locations

3239 Jefferson Ave
Ste 1
Cincinnati, OH 45220
Phone (997) 991-9276

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

904 Issac Sts
Oregon, OH 43616
Phone (419) 691-2483

3366 Riverside Dr
Ste 103
Upper Arlington, OH 43221
Phone (617) 958-5697

9200 Worthington Rd
Ste 300
Westerville, OH 43082
Phone (614) 888-7800

4176 State Route 306
Willoughby, OH 44094
Phone (440) 918-4630

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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 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": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497056642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781389",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781389",
            "telephone_number": "440-918-4690",
            "fax_number": "440-918-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4176 STATE ROUTE 306",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949203",
            "telephone_number": "440-918-4690",
            "fax_number": "440-918-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "11970-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3103171",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF AUTHORITY",
            "identifier": "RN 325805",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "NECZYPOR",
            "middle_name": "M",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.