Individual provider Active NPI

Chad R Sorenson, HIS

  • Hearing Instrument Specialist
  • Green Bay, WI
National Provider Identifier
1023266715
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1305-60 Issued in WI
Practice address
2314 Lineville Rd Ste 107
Green Bay, WI 54313-8860
Phone
(920) 434-6800
Fax
(920) 434-7084
NPI assigned
Sep 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1305-60 WI Primary

Addresses

Primary practice location

2314 Lineville Rd Ste 107
Green Bay, WI 54313-8860

Mailing address

2314 Lineville Rd Ste 107
Green Bay, WI 54313-8860
Phone (920) 434-6800

Other identifiers 1

IdentifierTypeStateIssuer
42840600MedicaidWI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1305-60WIMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Hearing Solutions LLC Hearing Instrument Specialist PastSince Jul 24, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023266715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 LINEVILLE RD STE 107",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138860",
            "telephone_number": "920-434-6800",
            "fax_number": "920-434-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 LINEVILLE RD STE 107",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138860",
            "telephone_number": "920-434-6800",
            "fax_number": "920-434-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "CHAD",
        "middle_name": "R",
        "credential": "HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1305-60",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42840600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.