Active NPI
Cynthia Herzog, M.S.
- Audiologist
- Portland, OR
National Provider Identifier
1013068865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 22540
- Practice address
- 921 NW 18TH Ave
Portland, OR 97209-2324 - Phone
- (503) 227-3666
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 22540 | OR | Primary |
Addresses
Primary practice location
921 NW 18TH Ave
Portland, OR 97209-2324
Mailing address
1926 W Burnside St
Unit 1602
Portland, OR 97209-2066
Phone (360) 713-8818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22540 | OR | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ear Medical Group a PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Otology & Neurotology Physician
- Portland, OR
- NPI 1841480746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222300800000",
"number": "1013068865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1926 W BURNSIDE ST",
"address_2": "UNIT 1602",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972092066",
"telephone_number": "360-713-8818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 NW 18TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972092324",
"telephone_number": "503-227-3666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERZOG",
"first_name": "CYNTHIA",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2008-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "22540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.