Active NPI
Amanda Carol Hartmann
- Pediatric Nurse Practitioner
- Chicago, IL
National Provider Identifier
1750796249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209014456
- Practice address
- 225 E Chicago Ave
Chicago, IL 60611-2991 - Phone
- (312) 227-3548
- Fax
- (312) 227-9640
- NPI assigned
- Jun 24, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | COA.15797-NP | OH | |
| Pediatric Nurse Practitioner | 363LP0200X | 209014456 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone (312) 227-3548
Other practice location 1
1 Perkins Sq
Akron, OH 44308-1063
Phone (330) 543-4970
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.15797-NP | OH | MD | Nurse Practitioner |
| 209014456 | IL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Medical Center of Akron | Current | Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Current | Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Current | Accepting new patients | |
| Lurie Children'S Medical Group, LLC | Past | Accepting new patients |
Locations
1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Akron, OH
- NPI 1841328853
-
- Anesthesiology Physician
- Boardman, OH
- NPI 1417257601
-
- Home Infusion Agency
- Akron, OH
- NPI 1649485848
-
- Pediatrics Physician
- Chicago, IL
- NPI 1992758544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1750796249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-3548",
"fax_number": "312-227-9640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-3548",
"fax_number": "312-227-9640"
}
],
"practiceLocations": [
{
"address_1": "1 Perkins Sq",
"address_purpose": "LOCATION",
"city": "Akron",
"state": "OH",
"postal_code": "443081063",
"country_code": "US",
"telephone_number": "330-543-4970",
"fax_number": "330-543-4971",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARTMANN",
"first_name": "AMANDA",
"middle_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-24",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COA.15797-NP",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209014456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.