Individual provider Active NPI

Jennifer Thomson, AUD

  • Audiologist
  • Bellefontaine, OH
National Provider Identifier
1023487261
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A02291 Issued in OH
Practice address
1134 N Main St Ste 3100
Bellefontaine, OH 43311-0017
Phone
(937) 651-3270
Fax
(937) 592-9789
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002622 NY
Audiologist 231H00000X A02291 OH Primary

Addresses

Primary practice location

1134 N Main St Ste 3100
Bellefontaine, OH 43311-0017

Mailing address

1134 N Main St Ste 3100
Bellefontaine, OH 43311-0017
Phone (937) 651-3270

Other practice location 1

510 E North Broadway St
Columbus, OH 43214-4114
Phone (614) 263-5151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210215001270 OH Practitioner - Qualified Audiologist 0244527992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Rutan HospitalGroup PAC ID 9032013792, 90 clinicians

Practice addresses (Care Compare)

1134 N Main St
Suite 3100
Bellefontaine, OH 43311-0017
Phone (937) 651-3270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002622NYMDMarriage & Family Therapist
A02291OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rutan Hospital CurrentSince Aug 1, 2024 Accepting new patients
Columbus Speech and Hearing Center Audiologist CurrentSince Feb 1, 2021 Accepting new patients
Mary Rutan Hospital Current Accepting new patients
Mary Rutan Hospital CurrentSince Aug 1, 2024 Accepting new patients
Mary Rutan Hospital Past Accepting new patients

Locations

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

1134 N Main St
Ste 3100
Bellefontaine, OH 43311
Phone (937) 651-6441

510 E North Broadway St
Columbus, OH 43214
Phone (614) 263-5151

209 Lippincott Ln
Urbana, OH 43078
Phone (937) 599-7058

Organizations & group practices 5

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1023487261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 N MAIN ST STE 3100",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433110017",
            "telephone_number": "937-651-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 N MAIN ST STE 3100",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433110017",
            "telephone_number": "937-651-3270",
            "fax_number": "937-592-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 E North Broadway St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432144114",
            "country_code": "US",
            "telephone_number": "614-263-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002622",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A02291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.