Individual provider Active NPI

Amy Lynn Hemann, LCSW

  • Clinical Social Worker
  • Maryville, IL
National Provider Identifier
1558598102
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6805 State Route 162 Ste 201
Maryville, IL 62062-8530
Phone
(618) 288-5019
Fax
(618) 288-5059
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6805 State Route 162 Ste 201
Maryville, IL 62062-8530

Mailing address

6805 State Route 162 Ste 201
Maryville, IL 62062-8530
Phone (618) 288-5019

Other practice location 1

16 Junction Dr W Ste 2
Glen Carbon, IL 62034-2996
Phone (618) 288-5019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090825000710 IL Practitioner - Clinical Social Worker 8921153040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Illinois Associates LLCGroup PAC ID 2961489992, 16 clinicians

Practice addresses (Care Compare)

6805 State Route 162
Suite 201
Maryville, IL 62062-8530
Phone (618) 288-5019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Associates LLC CurrentSince Jun 1, 2015 Accepting new patients
Psychiatric Urgent Care LLC CurrentSince Oct 2, 2022 Accepting new patients

Locations

16 Junction Dr W
#2
Glen Carbon, IL 62034
Phone (618) 288-5019

6805 State Route 162
#201
Maryville, IL 62062
Phone (618) 288-5019

6805 Highway 162
#201
Maryville, IL 62062
Phone (618) 288-5019

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17590/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/AFHDDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1558598102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 STATE ROUTE 162 STE 201",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628530",
            "telephone_number": "618-288-5019",
            "fax_number": "618-288-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 STATE ROUTE 162 STE 201",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628530",
            "telephone_number": "618-288-5019",
            "fax_number": "618-288-5059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Junction Dr W Ste 2",
            "address_purpose": "LOCATION",
            "city": "Glen Carbon",
            "state": "IL",
            "postal_code": "620342996",
            "country_code": "US",
            "telephone_number": "618-288-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEMANN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.