Individual provider Active NPI

Ashley Elizabeth Radcliffe, AU.D

  • Audiologist
  • Fayetteville, GA
National Provider Identifier
1063998425
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD004142 Issued in GA
Practice address
1240 Highway 54 W Ste 710
Fayetteville, GA 30214-4565
Phone
(770) 991-2800
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD004142 GA Primary

Addresses

Primary practice location

1240 Highway 54 W Ste 710
Fayetteville, GA 30214-4565

Mailing address

1240 Highway 54 W Ste 710
Fayetteville, GA 30214-4565
Phone (770) 991-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181010001955 GA Practitioner - Qualified Audiologist 4880946326 Reassigns benefits to 1 organization
I20241014004508 CT Practitioner - Qualified Audiologist 4880946326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Institute of Connecticut PLLCGroup PAC ID 4284078296, 25 clinicians

Practice addresses (Care Compare)

599 Farmington Ave
Suite 102
Farmington, CT 06032-2383
Phone (860) 284-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD004142GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Institute of Connecticut PLLC CurrentSince Sep 23, 2024 Accepting new patients
ENT of Georgia, LLC CurrentSince Nov 19, 2018 Accepting new patients
South Atlanta Ear Nose & Throat, PC CurrentSince Nov 19, 2018 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

4 Northwestern Dr
Ste 100
Bloomfield, CT 06002
Phone (860) 243-3344

599 Farmington Ave
Ste 102
Farmington, CT 06032
Phone (860) 284-4950

622 Hebron Ave
Ste 201
Glastonbury, CT 06033

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

515 Middle Tpke W
Manchester, CT 06040
Phone (860) 533-4176

1240 Highway 54 W
Ste 710
Fayetteville, GA 30214
Phone (678) 534-3309

830 Eagles Landing Pkwy
Ste 102
Stockbridge, GA 30281
Phone (678) 534-5922

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.518

Organizations & group practices 4

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1063998425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W STE 710",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144565",
            "telephone_number": "770-991-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W STE 710",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144565",
            "telephone_number": "770-991-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADCLIFFE",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD004142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.