Individual provider Active NPI

Anna Pham Stout, AUD

  • Audiologist
  • Sayre, PA
National Provider Identifier
1477081610
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006517 Issued in PA
Practice address
116 S Elmer Ave
Sayre, PA 18840-2006
Phone
(570) 887-2849
Fax
(570) 887-2244
NPI assigned
Jun 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT006517 PA Primary

Addresses

Primary practice location

116 S Elmer Ave
Sayre, PA 18840-2006

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other names 1

  • Anna Yeh Pham Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004002234 PA Practitioner - Qualified Audiologist 9739454547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

116 S Elmer Ave
Otolaryngology
Sayre, PA 18840-2006
Phone (570) 887-2849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT006517PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 28, 2017 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jul 28, 2017 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

116 S Elmer Ave
Sayre, PA 18840
Phone (570) 887-2849

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Organizations & group practices 4

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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1477081610",
    "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",
            "fax_number": "570-887-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S ELMER AVE",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188402006",
            "telephone_number": "570-887-2849",
            "fax_number": "570-887-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "ANNA",
        "middle_name": "PHAM",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "PHAM",
            "middle_name": "YEH",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.