Active NPI
Amy Shepardson Van Dusen, RN, NBC-HWC
- Orthopedic Registered Nurse
- Hermosa Beach, CA
National Provider Identifier
1912589482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Registered Nurse
- License
- 400575
- Practice address
- 567 24TH PL
Hermosa Beach, CA 90254-2608 - Phone
- (310) 994-0735
- NPI assigned
- Apr 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Registered Nurse | 163WX0800X | 400575 | CA | Primary |
Addresses
Primary practice location
567 24TH PL
Hermosa Beach, CA 90254-2608
Mailing address
567 24TH PL
Hermosa Beach, CA 90254-2608
Phone (310) 994-0735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 400575 | CA | MD | Orthopedic Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619222400000",
"number": "1912589482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "567 24TH PL",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902542608",
"telephone_number": "310-994-0735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "567 24TH PL",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902542608",
"telephone_number": "310-994-0735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DUSEN",
"first_name": "AMY",
"middle_name": "SHEPARDSON",
"credential": "RN, NBC-HWC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-24",
"last_updated": "2021-04-24",
"certification_date": "2021-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "163WX0800X",
"taxonomy_group": "",
"desc": "Registered Nurse, Orthopedic",
"state": "CA",
"license": "400575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hermosa Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.