Individual provider Active NPI

Amy Simmons Wynne, N.P.

  • Nurse Practitioner
  • Hammond, LA
National Provider Identifier
1710245691
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP06816 Issued in LA
Practice address
15790 Paul Vega MD Dr
Hospital Medicine Program
Hammond, LA 70403-1434
Phone
(985) 230-3066
Fax
(985) 230-2072
NPI assigned
Apr 27, 2012
Last updated
Sep 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP06816 LA Primary
Acute Care Nurse Practitioner 363LA2100X AP06816 LA

Addresses

Primary practice location

15790 Paul Vega MD Dr
Hospital Medicine Program
Hammond, LA 70403-1434

Mailing address

PO Box 2666
Hammond, LA 70404-2666
Phone (985) 230-3066

Other identifiers 1

IdentifierTypeStateIssuer
2191462MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20120611000542 LA Practitioner - Nurse Practitioner 6608030275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Oaks Medical Center LLCGroup PAC ID 2466629522, 317 clinicians

Practice addresses (Care Compare)

15790 Paul Vega MD Dr
Hammond, LA 70403-1434
Phone (985) 230-3066

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.91 of 100Reported as group
Quality
78.17
Promoting interoperability
100
Improvement activities
40
Cost
67.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Oaks Medical Center, LLC CurrentSince Apr 27, 2012 Accepting new patients
North Oaks Medical Center, LLC CurrentSince Apr 27, 2012 Accepting new patients

Locations

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

Organizations & group practices 2

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 1

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1710245691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2666",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042666",
            "telephone_number": "985-230-3066",
            "fax_number": "985-230-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15790 PAUL VEGA MD DR",
            "address_2": "HOSPITAL MEDICINE PROGRAM",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031434",
            "telephone_number": "985-230-3066",
            "fax_number": "985-230-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "AMY",
        "middle_name": "SIMMONS",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06816",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "AP06816",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2191462",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.