NPIMap

Individual provider Active NPI

Amy Elizabeth Wagner, CNP

  • Adult Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1760556856
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.0034631 Issued in OH
Practice address
625 Eden Park Dr
Cincinnati, OH 45202-6005
Phone
(513) 246-9155
Fax
(513) 487-4683
NPI assigned
Nov 20, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A18249 SC
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.0034631 OH Primary

Addresses

Primary practice location

625 Eden Park Dr
Cincinnati, OH 45202-6005

Mailing address

625 Eden Park Dr
Cincinnati, OH 45202-6005
Phone (513) 246-9155

Other practice location 1

955 Ribaut Road
Beaufort Memorial Hospital BMAC 4th Floor
Beaufort, SC 29902
Phone (843) 694-1722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210002143 OH Practitioner - Nurse Practitioner 5597868935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trihealth G LLCGroup PAC ID 0749222651, 294 clinicians

Practice addresses (Care Compare)

625 Eden Park Dr
Cincinnati, OH 45202-6005
Phone (513) 246-9155

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A18249SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Jan 13, 2025 Accepting new patients
Trihealth G LLC CurrentSince Jan 13, 2025 Accepting new patients
Trihealth G LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

Interoperability endpoints

  • Direct secure messaging: awagner452597@direct.trihealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1760556856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 EDEN PARK DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452026005",
            "telephone_number": "513-246-9155",
            "fax_number": "513-487-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 EDEN PARK DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452026005",
            "telephone_number": "513-246-9155",
            "fax_number": "513-487-4683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 Ribaut Road",
            "address_2": "Beaufort Memorial Hospital BMAC 4th Floor",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "29902",
            "country_code": "US",
            "telephone_number": "843-694-1722",
            "fax_number": "843-522-7430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "A18249",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.0034631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.