Amanda Churchill

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN.CNP.02067 Issued in OH

Practice address

6645 Morris Rd
Fairfield Township, OH 45011-5417

Phone

(513) 785-3700

Fax

(513) 785-3709

NPI assigned

Nov 30, 2016

Last updated

Nov 25, 2020By 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

Electronic endpoints 2

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Associates of SW Ohio IncGroup PAC ID 9638258874, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bridges Rehab at Home Home health agency, Mason, OH, CCN 368232
• Fort Hamilton Hughes Memorial Hospital Hospital, Hamilton, OH, CCN 360132
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

63.67

Promoting interoperability

100

Improvement activities

40

Cost

74.14

Merit-based Incentive Payment System (MIPS)

Final score

83.43 of 100Reported as group

Quality

70.97

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: achurchill668038@direct.ketteringhealth.org

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.

• Orthopedic Associates of SW Ohio, Inc

  • Orthopaedic Surgery Physician
  • Dayton, OH
  • NPI 1447422118
  Medicare reassignment Care Compare group NPD
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment NPD
• Orthopedic Associates of S W Ohio Inc,

  • Orthopaedic Surgery Physician
  • Fairborn, OH
  • NPI 1609387984
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alternate Solutions Homecare 3, LLC

  • Home Health Agency
  • Mason, OH
  • NPI 1679765747
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• The Fort Hamilton Hospital

  dba Kettering Health Hamilton

  • General Acute Care Hospital
  • Hamilton, OH
  • NPI 1104867167
  Care Compare affiliation

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1891238473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6645 MORRIS RD",
            "city": "FAIRFIELD TOWNSHIP",
            "state": "OH",
            "postal_code": "450115417",
            "telephone_number": "513-785-3700",
            "fax_number": "513-785-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6645 MORRIS RD",
            "city": "FAIRFIELD TOWNSHIP",
            "state": "OH",
            "postal_code": "450115417",
            "telephone_number": "513-785-3700",
            "fax_number": "513-785-3709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19262 OH-136",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "OH",
            "postal_code": "456979571",
            "country_code": "US",
            "telephone_number": "937-695-0770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "RN.380382",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.02067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6645 Morris Rd",
            "city": "Fairfield Township",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450115417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achurchill668038@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "6645 Morris Rd",
            "city": "Fairfield Township",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450115417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Butler County Community Health Consortium, Inc. (Primary Health Solutions)
• Britanie Byrd
• Gwendolyn Caithness Cameron
• Hajra Shahbaz Cheema, MD
• Aubrie Chiu
• Cityklue Inc
• Brittany Clayton
• Candis L Cochran
• Lynyanna Collins
• Angela K Combs, OTR/L

• Adult Health Nurse Practitioner in Fairfield Township, OH
• Providers in Fairfield Township, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.