Individual provider Active NPI

Amy E. Zamudio, CHW

  • Peer Specialist
  • Eugene, OR
National Provider Identifier
1952931719
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
THW000002461 Issued in OR
Practice address
195 W 12TH Ave
Eugene, OR 97401-3408
Phone
(541) 762-3300
Fax
(541) 684-4156
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Peer Specialist 175T00000X THW000002461 OR Primary

Addresses

Primary practice location

195 W 12TH Ave
Eugene, OR 97401-3408

Mailing address

687 Cheshire Ave
Eugene, OR 97402-5060
Phone (541) 684-4100

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

State licenses

LicenseStateTypeSpecialty
THW000002461ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1952931719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 CHESHIRE AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025060",
            "telephone_number": "541-684-4100",
            "fax_number": "541-684-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W 12TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013408",
            "telephone_number": "541-762-3300",
            "fax_number": "541-684-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMUDIO",
        "first_name": "AMY",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000002461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.