Amber Marie Dwan Grassman, RN/BSN
Individual provider Active NPI Gerontology Nurse Practitioner · Dalton, OH
NPI 1629643242 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1629643242
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- APRN.CNP.0033608 (OH)
- Practice address
- 13984 Lake Court Dr
Dalton, OH 44618-9291 - Phone
- (330) 749-2044
- Fax
- (330) 345-0001
- NPI assigned
- May 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Extended Care Specialists, Inc
Eventus Wholehealth Midwest Inc
Eventus Ecs, Inc
Neogeriatrics
Practice addresses (Care Compare)
3958 Brown Park Dr
Suite D
Hilliard, OH 43026-1160
Phone (260) 483-9081
4400 Easton CMNS
Suite 125
Columbus, OH 43219-6223
Phone (855) 743-2247
4808 Munson St NW
Canton, OH 44718-3613
Phone (330) 460-4115
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230509002720 | OH | Practitioner - Nurse Practitioner | 3476815044 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 364169 | OH | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Ecs - Ohio LLC | Current |
Accepting new patients | |
| Extended Care Specialists, Inc | Current |
Accepting new patients | |
| Neogeriatrics | Current |
Accepting new patients | |
| Eventus Wholehealth Midwest Inc | Current |
Accepting new patients | |
| Eventus Ecs, Inc | Current |
Accepting new patients | |
| Novus Health and Wellness | Past |
Accepting new patients |
Locations
4808 Munson St NW
Canton, OH 44718
Phone (330) 460-4115
4400 Easton Cmns
Ste 125
Columbus, OH 43219
Phone (514) 546-1900
3958 Brown Park Dr
Ste D
Hilliard, OH 43026
435 Avis Ave NW
Massillon, OH 44646
Phone (330) 837-1741
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 364169 | OH | |
| Gerontology Nurse Practitioner | 363LG0600X | APRN.CNP.0033608 | OH | Yes |
Addresses
Primary practice location
13984 Lake Court Dr
Dalton, OH 44618-9291
Mailing address
13984 Lake Court Dr
Dalton, OH 44618-9291
Phone (330) 749-2044
Other providers in Dalton, OH
- Dunlap Family Physicians, Inc.
- East Wayne Fire District
- Gregory Scottt Essig
- George M Kemper, Jr DPM Inc
- Melanie Gold
- Jonesys Lawn Care, Inc
- Connie Kandel
- Kari Ann Lawson
- Steven D Murray
- Peyton Michele Nussbaum
All providers in Dalton, OH · Gerontology Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.