Active NPI
Amy Michelle Wynn, NP
- Family Nurse Practitioner
- Seymour, IN
National Provider Identifier
1700359080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71008677A
- Practice address
- 410 S Chestnut St
Seymour, IN 47274 - Phone
- (812) 405-2125
- Fax
- (812) 405-2425
- NPI assigned
- Jan 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71008677A | IN | Primary |
Addresses
Primary practice location
410 S Chestnut St
Seymour, IN 47274
Mailing address
410 S Chestnut St
Seymour, IN 47274
Phone (812) 405-2125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
410 S Chestnut St
Seymour, IN 47274-2370
Phone (812) 405-2125
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71008677A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunrise Healthcare, LLC | Family | Current | Accepting new patients |
Locations
410 S Chestnut St
Seymour, IN 47274
Phone (812) 405-2125
Interoperability endpoints
- sunrisehealthcare.amywynn@161255.advancedmd-direct.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1700359080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 S CHESTNUT ST",
"city": "SEYMOUR",
"state": "IN",
"postal_code": "47274",
"telephone_number": "812-405-2125",
"fax_number": "812-405-2425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 S CHESTNUT ST",
"city": "SEYMOUR",
"state": "IN",
"postal_code": "47274",
"telephone_number": "812-405-2125",
"fax_number": "812-405-2425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNN",
"first_name": "AMY",
"middle_name": "MICHELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-09",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71008677A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seymour, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.