Individual provider Active NPI

Amy Ann Porter, AU.D., CCC-A

  • Audiologist
  • Logan, UT
National Provider Identifier
1649475633
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
6420052-4101 Issued in UT
Practice address
6410 Old Main HL
Logan, UT 84322-6410
Phone
(435) 797-1373
Fax
(844) 308-5865
NPI assigned
Jun 19, 2007
Last updated
Oct 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 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 6420052-4101 UT Primary

Addresses

Primary practice location

6410 Old Main HL
Logan, UT 84322-6410

Mailing address

6410 Old Main HL
Logan, UT 84322-6410
Phone (435) 797-1373

Other names 1

  • Amy Ann Raymond Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181109000066 UT Practitioner - Qualified Audiologist 0840544912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1350 N 500
Logan, UT 84341-2400
Phone (435) 716-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6420052-4101UTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Dec 25, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Dec 25, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1649475633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 OLD MAIN HL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843226410",
            "telephone_number": "435-797-1373",
            "fax_number": "844-308-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 OLD MAIN HL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843226410",
            "telephone_number": "435-797-1373",
            "fax_number": "844-308-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "AMY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "6420052-4101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "RAYMOND",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.