Individual provider Active NPI

Kerri S McDill, AU.D. CCC-A

  • Audiologist
  • Casper, WY
National Provider Identifier
1063564417
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A928 Issued in WY
Practice address
301 S Fenway St
Suite 203
Casper, WY 82601-3051
Phone
(307) 266-4100
Fax
(307) 266-4106
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Practitioner Audiologist 231HA2400X A-928 WY
Audiologist-Hearing Aid Fitter 237600000X A-928 WY
Hearing Instrument Specialist 237700000X A-928 WY
Assistive Technology Supplier Audiologist 231HA2500X A-928 WY
Audiologist 231H00000X A928 WY Primary
Speech/Language/Hearing Specialist/Technologist 235500000X A928 WY

Addresses

Primary practice location

301 S Fenway St
Suite 203
Casper, WY 82601-3051

Mailing address

301 S Fenway St
Suite 203
Casper, WY 82601-3053
Phone (307) 266-4100

Other identifiers 1

IdentifierTypeStateIssuer
306079MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090929000257 WY Practitioner - Qualified Audiologist 9133275407 Practice locations: Casper, WY

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 N Ash St
Suite 104
Casper, WY 82601-1875
Phone (307) 266-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A928WYMDAudiologist
A-928WYMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1063564417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S FENWAY ST",
            "address_2": "SUITE 203",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826013053",
            "telephone_number": "307-266-4100",
            "fax_number": "307-266-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S FENWAY ST",
            "address_2": "SUITE 203",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826013051",
            "telephone_number": "307-266-4100",
            "fax_number": "307-266-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDILL",
        "first_name": "KERRI",
        "middle_name": "S",
        "credential": "AU.D.  CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "WY",
            "license": "A-928",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WY",
            "license": "A-928",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WY",
            "license": "A-928",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "WY",
            "license": "A-928",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WY",
            "license": "A928",
            "primary": true
        },
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "WY",
            "license": "A928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306079",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; 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.