Individual provider Active NPI

Rachel Diana Liles

  • Audiologist
  • Liberty TWP, OH
National Provider Identifier
1043766025
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A02017 Issued in OH
Practice address
6724 Boxwood LN Apt a
Liberty TWP, OH 45044-1128
Phone
(513) 703-7557
NPI assigned
Aug 30, 2016
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A02017 OH Primary

Addresses

Primary practice location

6724 Boxwood LN Apt a
Liberty TWP, OH 45044-1128

Mailing address

6724 Boxwood LN Apt a
Liberty TWP, OH 45044-1128

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180122002106 OH Practitioner - Qualified Audiologist 3072872910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A02017OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio ENT Specialists Inc CurrentSince Jan 1, 2017 Accepting new patients
Family Speech & Hearing Clinic, LLC Audiologist Past Accepting new patients

Locations

1222 S Patterson Blvd
Ste 400
Dayton, OH 45402
Phone (937) 496-2600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDIFCD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1043766025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 BOXWOOD LN APT A",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450441128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 BOXWOOD LN APT A",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450441128",
            "telephone_number": "513-703-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "RACHEL",
        "middle_name": "DIANA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A02017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty TWP, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.