Individual provider Active NPI

Amy Hetrick

  • Student in an Organized Health Care Education/Training Program
  • Media, PA
National Provider Identifier
1518612357
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
524 N Providence Rd
Media, PA 19063-3056
Phone
(302) 345-8592
NPI assigned
Feb 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

524 N Providence Rd
Media, PA 19063-3056

Mailing address

904 Shetland CT
Chadds Ford, PA 19317-9295
Phone (302) 345-8592

Other practice location 1

904 Shetland Ct
Chadds Ford, PA 19317-9295
Phone (302) 345-8592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1518612357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SHETLAND CT",
            "city": "CHADDS FORD",
            "state": "PA",
            "postal_code": "193179295",
            "telephone_number": "302-345-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 N PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633056",
            "telephone_number": "302-345-8592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 Shetland Ct",
            "address_purpose": "LOCATION",
            "city": "Chadds Ford",
            "state": "PA",
            "postal_code": "193179295",
            "country_code": "US",
            "telephone_number": "302-345-8592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HETRICK",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.