Individual provider Active NPI

Jessica J Trawick-Edwards, AUDIOLOGY TECH

  • Audiology Assistant
  • Fort Rucker, AL
National Provider Identifier
1073081113
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiology AssistantTaxonomy code 2355A2700X
License
187805A Issued in AL
Practice address
Lyster Army Health Clinic
Building 301 Andrews Avenue
Fort Rucker, AL 36362-5333
Phone
(334) 255-7185
NPI assigned
Nov 7, 2018
Last updated
Nov 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiology Assistant 2355A2700X 187805A AL Primary

Addresses

Primary practice location

Lyster Army Health Clinic
Building 301 Andrews Avenue
Fort Rucker, AL 36362-5333

Mailing address

Lyster Army Health Clinic
Building 301 Andrews Avenue
Fort Rucker, AL 36362-5333
Phone (334) 255-7185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
187805AALMDAudiology Assistant

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1073081113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LYSTER ARMY HEALTH CLINIC",
            "address_2": "BUILDING 301 ANDREWS AVENUE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LYSTER ARMY HEALTH CLINIC",
            "address_2": "BUILDING 301 ANDREWS AVENUE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAWICK-EDWARDS",
        "first_name": "JESSICA",
        "middle_name": "J",
        "credential": "AUDIOLOGY TECH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355A2700X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Audiology Assistant",
            "state": "AL",
            "license": "187805A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.