Individual provider Active NPI

Amber McLouth, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1043386022
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3106 Issued in AZ
Practice address
4530 E Muirwood Dr Ste 111
Phoenix, AZ 85048-7693
Phone
(480) 961-2365
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3106 AZ Primary

Addresses

Primary practice location

4530 E Muirwood Dr Ste 111
Phoenix, AZ 85048-7693

Mailing address

4530 E Muirwood Dr
Ste 111
Phoenix, AZ 85048-7693

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20091026000591 AZ Practitioner - Physician Assistant 7618014507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Neurology P CGroup PAC ID 6507757234, 24 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 111
Phoenix, AZ 85048-7693
Phone (480) 961-2365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3106AZMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: amber.mclouth.1@8409.direct.athenahealth.com

Organizations & group practices 1

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1043386022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR",
            "address_2": "STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693",
            "telephone_number": "480-961-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLOUTH",
        "first_name": "AMBER",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.