Individual provider Active NPI

Amy Catherine Roy, NPC

  • Family Nurse Practitioner
  • Ionia, MI
National Provider Identifier
1538166186
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704217807 Issued in MI
Practice address
431 Swartz CT. Ste. 200
Ionia, MI 48846
Phone
(616) 841-2615
Fax
(616) 828-1752
NPI assigned
Jun 28, 2005
Last updated
Mar 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 4704217807 MI Primary

Addresses

Primary practice location

431 Swartz CT. Ste. 200
Ionia, MI 48846

Mailing address

431 Swartz CT. Ste. 200
Ionia, MI 48846
Phone (616) 841-2615

Other identifiers 1

IdentifierTypeStateIssuer
4636668-10MedicaidMI

Other names 1

  • Ms. Amy Catherine Anglin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20041015000542 MI Practitioner - Nurse Practitioner 9739149527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Pain Solutions PLLCGroup PAC ID 2163657339, 4 clinicians

Practice addresses (Care Compare)

431 Swartz CT
Suite 200
Ionia, MI 48846-2161
Phone (616) 841-2615

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704217807MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Solutions PLLC Nurse Practitioner CurrentSince Nov 6, 2017 Accepting new patients
Advanced Pain Solutions, PLLC CurrentSince Nov 6, 2017 Accepting new patients

Locations

1000 East Paris Ave SE
Ste 221
Grand Rapids, MI 49546
Phone (616) 222-0770

3322 Beltline Ct NE
Ste 200
Grand Rapids, MI 49525

431 Swartz Ct
Ste 200
Ionia, MI 48846
Phone (616) 841-2615

Organizations & group practices 2

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 1

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1538166186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 SWARTZ CT. STE. 200",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "48846",
            "telephone_number": "616-841-2615",
            "fax_number": "616-828-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 SWARTZ CT. STE. 200",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "48846",
            "telephone_number": "616-841-2615",
            "fax_number": "616-828-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "AMY",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704217807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4636668-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ANGLIN",
            "middle_name": "CATHERINE",
            "prefix": "MS.",
            "credential": "NPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ionia, MI

Sources for this page

Verify at the official NPI Registry.