Amber D Lutz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000657A Issued in IN

Practice address

1202 W Buena Vista Rd.
Suite #100
Evansville, IN 47710-5185

Phone

(812) 429-1520

Fax

(812) 429-1523

NPI assigned

Jun 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amber D Fetcher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Rick Crawford MD

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1023459880
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1750387387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W BUENA VISTA RD.",
            "address_2": "SUITE # 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105185",
            "telephone_number": "812-429-1520",
            "fax_number": "812-429-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W BUENA VISTA RD.",
            "address_2": "SUITE #100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477105185",
            "telephone_number": "812-429-1520",
            "fax_number": "812-429-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "AMBER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002198",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000657A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970010159",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "FETCHER",
            "middle_name": "D",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• McKenzie Lueken
• Yulie Lugo
• Paige Madison Luigs, DPT
• Thea Leigh Luigs, LCSW
• Eric Lawrence Lund, MT-BC
• Kyle A Lutz, PA
• Melanie Lutz, AGNP-C
• Luxottica of America Inc. (Lenscrafters #625)
• Michael Wata Luy, MD
• Mark B Luzader, MSW LCSW

• Physician Assistant in Evansville, IN
• Providers in Evansville, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.