Amanda Gougler

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

IN MAIL Issued in UT

Practice address

2240 Adams Ave
Ogden, UT 84401-1511

Phone

(801) 393-5355

Fax

(801) 394-4609

NPI assigned

Sep 22, 2015

Last updated

Sep 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/32350/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midtown Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ogden, UT
  • NPI 1548267420
  Medicare reassignment NPD
• Midtown Community Health Center Inc

  dba MTCHC Logan Clinic

  • Federally Qualified Health Center (FQHC)
  • Logan, UT
  • NPI 1053780171
  NPD

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1346619285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N CUTLER DR APT 631",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840545066",
            "telephone_number": "801-725-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011511",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGLER",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "IN MAIL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramsey Lee Gosselin, FNP
• Stephanie Goth
• Gary K Goucher, MD
• Nicholas R Goucher, M.D.
• Julie Goudie-Nice, PHD
• Ashley Burnett Govel
• Chandrakala B Gowda, M.D
• Grace & Peace Christian Counseling
• Kimberly A. F. Graf, D.C.
• David Matthew Graff, D.P.M

• Physician Assistant in Ogden, UT
• Providers in Ogden, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.