Active NPI
Pamela Jean Ennis, CRNA
- Certified Registered Nurse Anesthetist
- Sayre, PA
National Provider Identifier
1174582910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN318594L
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- NPI assigned
- Mar 21, 2006
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN318594L | PA | Primary |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430066788 | Other | PA | RR MEDICARE PIN |
| GU039832 | Other | PA | MEDICARE GROUP |
| CC9269 | Other | PA | RR MEDICARE GROUP |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Clinic LTD | Past | Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Endoscopy Clinic/Center
- Sayre, PA
- NPI 1831144047
-
- Family Medicine Physician
- Troy, PA
- NPI 1376592493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1174582910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNIS",
"first_name": "PAMELA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "PA",
"license": "RN318594L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "430066788",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "GU039832",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC9269",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sayre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.