Individual provider Active NPI

Tammy Alleen Ellis, CCC-A

  • Audiologist-Hearing Aid Fitter
  • Jasper, AL
National Provider Identifier
1023268356
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
0768A Issued in AL
Practice address
3400 Highway 78 E
205 Medical Arts Tower
Jasper, AL 35501-8907
Phone
(205) 221-4630
Fax
(205) 221-4731
NPI assigned
Sep 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 0768A AL Primary
Audiologist 231H00000X 0768A AL

Addresses

Primary practice location

3400 Highway 78 E
205 Medical Arts Tower
Jasper, AL 35501-8907

Mailing address

833 Saint Vincents Dr
Pob#3 Suite 402
Birmingham, AL 35205-1606
Phone (205) 933-9236

Other identifiers 2

IdentifierTypeStateIssuer
51598737OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
113797MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000145 AL Practitioner - Qualified Audiologist 5092871384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Associates of Alabama PCGroup PAC ID 8921025354, 43 clinicians

Practice addresses (Care Compare)

3400 Hwy 78 E
Suite 205
Jasper, AL 35501-8950
Phone (205) 933-9277

Merit-based Incentive Payment System (MIPS)

Final score
90.23 of 100Reported as group
Quality
90.13
Promoting interoperability
100
Improvement activities
40
Cost
77.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0768AALMDAudiologist-Hearing Aid Fitter

Networks

  • FL PPO
  • MS PPO D-SNP
  • MS PPO
  • MS PPO C-SNP

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1023268356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR",
            "address_2": "POB#3 SUITE 402",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051606",
            "telephone_number": "205-933-9236",
            "fax_number": "205-933-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HIGHWAY 78 E",
            "address_2": "205 MEDICAL ARTS TOWER",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018907",
            "telephone_number": "205-221-4630",
            "fax_number": "205-221-4731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TAMMY",
        "middle_name": "ALLEEN",
        "name_prefix": "Mrs.",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AL",
            "license": "0768A",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "0768A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51598737",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113797",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.