Pamela Jeanne Cronin, MS, CCC-A
Individual provider Active NPI Audiologist · West Jordan, UT
NPI 1639109481 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1639109481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 107983-4101 (UT)
- Practice address
- 3584 W 9000 S
Suite 311
West Jordan, UT 84088-4775 - Phone
- (801) 566-8304
- Fax
- (801) 566-8330
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South Valley Ear Nose and Throat Associates PLLC
Practice addresses (Care Compare)
3584 W 9000
Suite 311
West Jordan, UT 84088-4775
Phone (801) 566-8304
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040625000805 | UT | Practitioner - Qualified Audiologist | 7911983440 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107983-4101 | UT | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Valley Ear Nose and Throat Associates, PLLC | Current |
Accepting new patients |
Locations
1225 E Fort Union Blvd
Ste 120
Midvale, UT 84047
Phone (801) 563-1116
4651 W 13400 S
Ste 120
Riverton, UT 84096
3584 W 9000 S
Ste 311
West Jordan, UT 84088
Phone (801) 566-8304
Interoperability endpoints
- southvalleyent.pamelacronin@153057.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 107983-4101 | UT | Yes |
Addresses
Primary practice location
3584 W 9000 S
Suite 311
West Jordan, UT 84088-4775
Mailing address
3584 W 9000 S
Suite 311
West Jordan, UT 84088-4775
Phone (801) 566-8304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470897660008 | Medicaid | UT |
Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.