Active NPI
Amanda Grace Stout
- Pharmacist
- Danville, PA
National Provider Identifier
1083079636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP442733
- Practice address
- 200 State Hospital Dr
Danville, PA 17821-9103 - Phone
- (570) 271-4500
- NPI assigned
- Dec 28, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP442733 | PA | Primary |
Addresses
Primary practice location
200 State Hospital Dr
Danville, PA 17821-9103
Mailing address
200 State Hospital Dr
Danville, PA 17821
Phone (570) 898-2175
Other names 1
- Amanda Grace Carr
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP442733 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennsylvania Department of Public Welfare | Past | Accepting new patients |
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.
-
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- Allentown, PA
- NPI 1386626919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451260800000",
"number": "1083079636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 STATE HOSPITAL DR",
"city": "DANVILLE",
"state": "PA",
"postal_code": "17821",
"telephone_number": "570-898-2175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 STATE HOSPITAL DR",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178219103",
"telephone_number": "570-271-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "AMANDA",
"middle_name": "GRACE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-28",
"last_updated": "2015-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP442733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "CARR",
"middle_name": "GRACE",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.