Individual provider Active NPI

Amy Marie Gruwell, FNP

  • Nurse Practitioner
  • Casper, WY
National Provider Identifier
1699761585
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19507.318 Issued in WY
Practice address
1900 E 1St St
Casper, WY 82601-2747
Phone
(307) 577-7737
Fax
(307) 577-0049
NPI assigned
Sep 26, 2005
Last updated
May 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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 19507.318 WY Primary

Addresses

Primary practice location

1900 E 1St St
Casper, WY 82601-2747

Mailing address

1900 E 1St St
Casper, WY 82601-2747
Phone (307) 577-7737

Other identifiers 3

IdentifierTypeStateIssuer
120223500MedicaidWY
315275OtherWYBC/BS
611665901OtherWYDEPT OF LABOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20041202000501 WY Practitioner - Nurse Practitioner 5890751796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Platte River Family Practice LLCGroup PAC ID 6800945189, 3 clinicians

Practice addresses (Care Compare)

1900 E 1St St
Casper, WY 82601-2747
Phone (307) 577-7737

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19507.318WYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Platte River Family Practice LLC CurrentSince Jun 1, 2009 Accepting new patients

Locations

1900 E 1st St
Casper, WY 82601
Phone (307) 577-7737

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJGGAA/Endpoint/AJGGAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1699761585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E 1ST ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012747",
            "telephone_number": "307-577-7737",
            "fax_number": "307-577-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E 1ST ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012747",
            "telephone_number": "307-577-7737",
            "fax_number": "307-577-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUWELL",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WY",
            "license": "19507.318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120223500",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "315275",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "611665901",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.