NPIMap

Organization Active NPI

Audiology Consultants of Southern Oregon, Inc.

  • Audiologist
  • Roseburg, OR
National Provider Identifier
1003009325
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
22652 Issued in OR
Legal business name
AUDIOLOGY CONSULTANTS OF SOUTHERN OREGON, INC.
Practice address
1367 W Harvard Ave
Roseburg, OR 97470-2838
Phone
(541) 672-8868
Fax
(541) 672-1142
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Celia Gallegos
Title
Billing Associate
Phone
(541) 672-8868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 22652 OR Primary

Addresses

Primary practice location

1367 W Harvard Ave
Roseburg, OR 97470-2838

Mailing address

1367 W Harvard Ave
Roseburg, OR 97470-2838
Phone (541) 672-8868

Other practice location 1

1931 NW Mulholland Dr
Roseburg, OR 97470-6500
Phone (541) 672-8868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071112000156 OR Part B Supplier - Clinic/Group Practice 2062500929 Receives reassigned benefits from 2 practitioners
Practice locations: Roseburg, OR

National Provider Directory

National Provider Directory

Locations

1367 W Harvard Ave
Roseburg, OR 97471
Phone (541) 672-8868

2300 NW Stewart Pkwy
Ste 103
Roseburg, OR 97471
Phone (541) 672-8868

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1003009325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702838",
            "telephone_number": "541-672-8868",
            "fax_number": "541-672-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702838",
            "telephone_number": "541-672-8868",
            "fax_number": "541-672-1142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1931 NW Mulholland Dr",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974706500",
            "country_code": "US",
            "telephone_number": "541-672-8868",
            "fax_number": "541-672-1142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUDIOLOGY CONSULTANTS OF SOUTHERN OREGON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "BILLING ASSOCIATE",
        "authorized_official_telephone_number": "541-672-8868"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "OR",
            "license": "22652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.