Active NPI
Amber Nicole Hines, CRNA
- Certified Registered Nurse Anesthetist
- Waterloo, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- D-110691
- Practice address
- 1825 Logan Ave
Waterloo, IA 50703-1916 - Phone
- (319) 235-5386
- Fax
- (319) 235-3074
- NPI assigned
- Jul 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 110691 | IA | |
| Certified Registered Nurse Anesthetist | 367500000X | D-110691 | IA | Primary |
Addresses
Primary practice location
1825 Logan Ave
Waterloo, IA 50703-1916
Mailing address
4150 Kimball Ave
PO Box 2758
Waterloo, IA 50701-9086
Phone (319) 235-5390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629232855 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
201 E J Ave
Grundy Center, IA 50638-2028
Phone (319) 824-5421
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110691 | IA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Medical Center New Hampton | Current | Accepting new patients | |
| Waverly Health Center | Current | Accepting new patients | |
| Grundy County Memorial Hospital | Current | Accepting new patients | |
| Waverly Health Center | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
201 E J Ave
Grundy Center, IA 50638
Phone (319) 824-5081
312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Access Hospital
- Grundy Center, IA
- NPI 1821055989
-
- Critical Access Hospital
- New Hampton, IA
- NPI 1770651515
-
- Certified Registered Nurse Anesthetist
- Waverly, IA
- NPI 1033125463
Nurse Anesthetist, Certified Registered
-
- Emergency Medicine Physician
- Grundy Center, IA
- NPI 1114012085
-
- Rural Health Clinic/Center
- Janesville, IA
- NPI 1184094534
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Grundy Center, IA
- NPI 1821055989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332979200000",
"number": "1629232855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 KIMBALL AVE",
"address_2": "PO BOX 2758",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507019086",
"telephone_number": "319-235-5390",
"fax_number": "319-235-5607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 LOGAN AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031916",
"telephone_number": "319-235-5386",
"fax_number": "319-235-3074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "AMBER",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2012-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "110691",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IA",
"license": "D-110691",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629232855",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.