Amy Lynne Roberts, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704205287 Issued in MI

Practice address

451 Health Pkwy
Suite B
Paw Paw, MI 49079-8242

Phone

(269) 655-3065

Fax

(269) 655-0588

NPI assigned

Nov 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Amy Lynne Quertermus Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org
• Direct secure messaging: aroberts9721@direct.bronsonhg.org

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.

• Bronson Lakeview Hospital

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137

  Nurse Practitioner

  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Physician Assistant
  • Kalamazoo, MI
  • NPI 1013089820
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Bronson Lakeview Hospital

  • Rural Health Clinic/Center
  • South Haven, MI
  • NPI 1801538871
  NPD

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1881677383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE B",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-655-3065",
            "fax_number": "269-655-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE B",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-655-3065",
            "fax_number": "269-655-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "AMY",
        "middle_name": "LYNNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704205287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4939773",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "500H010410",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "QUERTERMUS",
            "middle_name": "LYNNE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Riffer-Reinert, LMSW
• Victoria Elizabeth Risinger
• Joe Martine Rivera
• Christine Roach-Brown
• Teagan Roark
• Olivia Kate Robertson, MA
• Rachel Rose Robertson, MA, LLPC
• Bailey K Robinson
• Cindy Marie Roman, LMSW
• Joseph Henry Romph, RPH

• Nurse Practitioner in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.

Verify at the official NPI Registry.