Amanda Lerae Aemisegger, MD
Individual provider Active NPI Emergency Medicine Physician · Columbus, OH
NPI 1639334584 · NPPES record last updated Apr 26, 2011
Key facts
- NPI
- 1639334584
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 57.014575 (OH)
- Practice address
- 1654 Upham Dr
167 Means Hall
Columbus, OH 43210-1250 - Phone
- (614) 293-3551
- Fax
- (614) 293-3124
- NPI assigned
- Jul 21, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110713000574 | OH | Practitioner - Emergency Medicine | 0547438723 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.014575 | OH | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Emergency Physicians LLC | Emergency Medicine | Current |
Accepting new patients |
Locations
48439 Genesis Dr
Ste A
Coshocton, OH 43812
Phone (740) 454-4000
301 Mike Clouse Dr
Somerset, OH 43783
Phone (740) 654-6213
2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 57.014575 | OH | Yes |
Addresses
Primary practice location
1654 Upham Dr
167 Means Hall
Columbus, OH 43210-1250
Mailing address
1654 Upham Dr
167 Means Hall
Columbus, OH 43210-1250
Phone (614) 293-3551
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All providers in Columbus, OH · Emergency Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2011. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.