Individual provider Active NPI

Amanda Christine Lynen

  • Student in an Organized Health Care Education/Training Program
  • Philadelphia, PA
National Provider Identifier
1841043205
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone
(215) 955-6864
Fax
(215) 955-2878
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005

Mailing address

1015 Walnut St Ste 620
Philadelphia, PA 19107-5005
Phone (215) 955-6864

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715004342 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 5294270146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1841043205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005",
            "telephone_number": "215-955-6864",
            "fax_number": "215-955-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WALNUT ST STE 620",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075005",
            "telephone_number": "215-955-6864",
            "fax_number": "215-955-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNEN",
        "first_name": "AMANDA",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.