Individual provider Active NPI

Pamela R. Wood, M.S., CCC-A

  • Audiologist
  • Tucson, AZ
National Provider Identifier
1104854538
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA536 Issued in AZ
Practice address
1661 N Swan Rd
Suite 220
Tucson, AZ 85712-4042
Phone
(520) 325-8899
Fax
(520) 325-0699
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA536 AZ Primary

Addresses

Primary practice location

1661 N Swan Rd
Suite 220
Tucson, AZ 85712-4042

Mailing address

1661 N Swan Rd
Suite 220
Tucson, AZ 85712-4042
Phone (520) 325-8899

Other identifiers 2

IdentifierTypeStateIssuer
AZ0303040OtherAZBLUE CROSS/BLUE SHIELD
P00243100OtherAZRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051107000350 AZ Practitioner - Qualified Audiologist 7911925128 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DA536AZMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Hearing Care Inc Audiologist-Hearing Aid Fitter CurrentSince Sep 26, 2012 Accepting new patients

Locations

1661 N Swan Rd
Ste 220
Tucson, AZ 85712
Phone (520) 325-8899

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1104854538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 N SWAN RD",
            "address_2": "SUITE 220",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124042",
            "telephone_number": "520-325-8899",
            "fax_number": "520-325-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 N SWAN RD",
            "address_2": "SUITE 220",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124042",
            "telephone_number": "520-325-8899",
            "fax_number": "520-325-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "PAMELA",
        "middle_name": "R.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0303040",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00243100",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.