Individual provider Active NPI

Amanda L. Pummell, APRN

  • Nurse Practitioner
  • Centerville, OH
National Provider Identifier
1700770070
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0039367 Issued in OH
Practice address
2350 Miami Valley Dr Ste 310
Centerville, OH 45459-4778
Phone
(937) 438-5216
NPI assigned
Jun 3, 2025
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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 APRN.CNP.0039367 OH Primary

Addresses

Primary practice location

2350 Miami Valley Dr Ste 310
Centerville, OH 45459-4778

Mailing address

4188 Maxwell Dr
Bellbrook, OH 45305-1627
Phone (330) 464-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250728000785 OH Practitioner - Nurse Practitioner 3577070366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

2350 Miami Valley Dr
Suite 310
Centerville, OH 45459-4778
Phone (937) 438-5216

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Nurse Practitioner CurrentSince Jul 14, 2025 Accepting new patients
Premier Health Specialists Inc CurrentSince Jul 14, 2025 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

2350 Miami Valley Dr
Ste 310
Dayton, OH 45459
Phone (937) 435-4263

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 3

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 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": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1700770070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4188 MAXWELL DR",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051627",
            "telephone_number": "330-464-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MIAMI VALLEY DR STE 310",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594778",
            "telephone_number": "937-438-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMMELL",
        "first_name": "AMANDA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0039367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.