Individual provider Active NPI

Amber N Ridgeway, NP

  • Family Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1649786906
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.016627 Issued in IL
Practice address
1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800
Phone
(217) 422-6100
Fax
(833) 784-5326
NPI assigned
Dec 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.016627 IL Primary
Cardiovascular Disease Physician 207RC0000X 209.016627 IL

Addresses

Primary practice location

1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800

Mailing address

1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800
Phone (217) 422-6100

Other practice location 1

1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 422-6100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aridgeway168148@ewd.direct.hshs.org Direct

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180208000045 IL Practitioner - Nurse Practitioner 9931469111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 E Lake Shore Dr
St Marys
Decatur, IL 62521-3883
Phone (217) 464-2870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.016627ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Cardiovascular Consultants LTD Cardiovascular Disease CurrentSince Jan 2, 2018 Accepting new patients

Locations

409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565

1770 E Lake Shore Dr
Ste 105
Decatur, IL 62521
Phone (217) 329-1000

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

3 Saint Elizabeth Blvd
Ste 2800
O Fallon, IL 62269
Phone (618) 233-6044

619 E Mason St
Ste 4P57
Springfield, IL 62701

619 E Mason St
Ste 4
Springfield, IL 62701

619 E Mason St
#4P57
Springfield, IL 62701

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1649786906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR STE 105",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213800",
            "telephone_number": "217-422-6100",
            "fax_number": "833-784-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR STE 105",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213800",
            "telephone_number": "217-422-6100",
            "fax_number": "833-784-5326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 E Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625213810",
            "country_code": "US",
            "telephone_number": "217-422-6100",
            "fax_number": "217-422-3217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "AMBER",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-22",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.016627",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "209.016627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aridgeway168148@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1770 E Lake Shore Dr Ste 105",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625213800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.