Individual provider Active NPI

Richard C Anesko, AU.D.

  • Audiologist
  • Sierra Vista, AZ
National Provider Identifier
1023312741
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA1790 Issued in AZ
Practice address
157 N. Coronado Drive Suite B
Sierra Vista Rural Health Care Center
Sierra Vista, AZ 85635
Phone
(520) 629-4802
NPI assigned
Jan 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA1790 AZ Primary

Addresses

Primary practice location

157 N. Coronado Drive Suite B
Sierra Vista Rural Health Care Center
Sierra Vista, AZ 85635

Mailing address

157 N Coronado Dr
Suite B
Sierra Vista, AZ 85635-6360
Phone (520) 629-4802

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
DA1790AZMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1023312741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 N CORONADO DR",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356360",
            "telephone_number": "520-629-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 N. CORONADO DRIVE SUITE B",
            "address_2": "SIERRA VISTA RURAL HEALTH CARE CENTER",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-629-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANESKO",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-10",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA1790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.