Individual provider Active NPI

Amy E Matla, CRNP

  • Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1679393516
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP024857 Issued in PA
Practice address
6081 Hamilton Blvd Ste 600
Allentown, PA 18106-9801
Phone
(440) 517-8946
NPI assigned
Oct 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP024857 PA Primary

Addresses

Primary practice location

6081 Hamilton Blvd Ste 600
Allentown, PA 18106-9801

Mailing address

5265 Rockrose LN BLDG J38
Allentown, PA 18104-8265
Phone (484) 894-7991

Other names 1

  • Amy E Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP024857PAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1679393516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 ROCKROSE LN BLDG J38",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181048265",
            "telephone_number": "484-894-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6081 HAMILTON BLVD STE 600",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069801",
            "telephone_number": "440-517-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLA",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP024857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MILLER",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.