Individual provider Active NPI

Haiden Alizabeth Nunn, AUD

  • Audiologist
  • Watkinsville, GA
National Provider Identifier
1033778089
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD004186 Issued in GA
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

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
AUD004186OtherGALICENSING BOARD
Q19431AOtherMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190830002869 GA Practitioner - Qualified Audiologist 3779812680 Reassigns benefits to 1 organization

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
Athens Oconee Audiology LLCGroup PAC ID 4688846603, 3 clinicians

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

LicenseStateTypeSpecialty
AUD004186GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Oconee Audiology LLC CurrentSince Apr 28, 2022 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.

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.

Verify at the official NPI Registry.