Amy Holmgren, APRN, MPH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209019256 Issued in IL

Practice address

3010 Grand Ave
Waukegan, IL 60085-2321

Phone

(847) 377-8950

Fax

(847) 948-5602

NPI assigned

May 21, 2013

Last updated

Aug 6, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Josselyn Center NFPGroup PAC ID 0840289740, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Josselyn Center NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northbrook, IL
  • NPI 1073548640
  Medicare reassignment Care Compare group NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1174552293
  NPD
• The Josselyn Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northfield, IL
  • NPI 1588337588
  NPD
• The Josselyn Center NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grayslake, IL
  • NPI 1841078714
  NPD
• The Josselyn Center NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northbrook, IL
  • NPI 1457011934
  NPD (past)

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1841636503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8950",
            "fax_number": "847-948-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMGREN",
        "first_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "APRN, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041244670",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209019256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.