Active NPI
Haiden Alizabeth Nunn, AUD
- Audiologist
- Watkinsville, GA
National Provider Identifier
1033778089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AUD004186
- Practice address
- 1360 Caduceus Way Ste 101
Watkinsville, GA 30677-7300 - Phone
- (706) 310-7115
- NPI assigned
- Jun 12, 2019
- 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 | AUD004186 | GA | Primary |
Addresses
Primary practice location
1360 Caduceus Way Ste 101
Watkinsville, GA 30677-7300
Mailing address
1360 Caduceus Way
Building 200, Suite 101
Watkinsville, GA 30677-7300
Phone (706) 310-7115
Other practice location 1
4045 Johns Creek Pkwy Ste B
Suwanee, GA 30024-1218
Phone (770) 814-1260
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AUD004186 | Other | GA | LICENSING BOARD |
| Q19431A | Other | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1360 Caduceus Way
Watkinsville, GA 30677-7212
Phone (706) 310-7115
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AUD004186 | GA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athens Oconee Audiology LLC | Current | Accepting new patients |
Locations
1360 Caduceus Way
Bldg 200
Watkinsville, GA 30677
Phone (706) 310-7115
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.
-
- Hearing and Speech Clinic/Center
- Watkinsville, GA
- NPI 1114209970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1033778089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 CADUCEUS WAY",
"address_2": "BUILDING 200, SUITE 101",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306777300",
"telephone_number": "706-310-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 CADUCEUS WAY STE 101",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306777300",
"telephone_number": "706-310-7115"
}
],
"practiceLocations": [
{
"address_1": "4045 Johns Creek Pkwy Ste B",
"address_purpose": "LOCATION",
"city": "Suwanee",
"state": "GA",
"postal_code": "300241218",
"country_code": "US",
"telephone_number": "770-814-1260",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NUNN",
"first_name": "HAIDEN",
"middle_name": "ALIZABETH",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "GA",
"license": "AUD004186",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSING BOARD",
"identifier": "AUD004186",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "Q19431A",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Watkinsville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.