Individual provider Active NPI

Amy B Lannoye, CRNA

  • Certified Registered Nurse Anesthetist
  • Green Bay, WI
National Provider Identifier
1952582264
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
125895 Issued in WI
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 445-7226
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 125895 WI Primary

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

PO Box 23400
Green Bay, WI 54305-3400
Phone (920) 445-7226

Other identifiers 1

IdentifierTypeStateIssuer
44329200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040601000066 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153214168 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services of the Fox Valley SCGroup PAC ID 1658345228, 16 clinicians

Practice addresses (Care Compare)

4648 W Spencer St
Appleton, WI 54914-9106
Phone (920) 731-7557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
3672WIMDPhysical Therapist
125895WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Osms Anesthesia LLC CurrentSince Oct 6, 2024 Accepting new patients
Green Bay Anesthesia Assoc. SC CurrentSince May 15, 2021 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Feb 8, 2018 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 8, 2018 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Feb 8, 2018 Accepting new patients
Bellin Anesthesia Associates, S.C. CurrentSince Jul 24, 2021 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients

Locations

225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026

2223 Lime Kiln Rd
Ste 1
Green Bay, WI 54311
Phone (920) 468-0246

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

Bin 88848
Milwaukee, WI 53288

Bin 88263
Milwaukee, WI 53288

1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1952582264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23400",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543053400",
            "telephone_number": "920-445-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANNOYE",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "125895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44329200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.