Active NPI
Virginia G Boyle, AUD CCC A SLP
- Audiologist
- Diamondhead, MS
National Provider Identifier
1073519211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A1020
- Practice address
- 5439 W Aloha Dr
Ste B
Diamondhead, MS 39525-3374 - Phone
- (228) 255-8889
- Fax
- (228) 255-0890
- NPI assigned
- Jun 22, 2005
- Last updated
- Aug 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | A1020 | MS | Primary |
| Speech-Language Pathologist | 235Z00000X | S1020 | MS |
Addresses
Primary practice location
5439 W Aloha Dr
Ste B
Diamondhead, MS 39525-3374
Mailing address
5439 W Aloha Dr
Ste B
Diamondhead, MS 39525-3374
Phone (228) 255-8889
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09015355 | Medicaid | MS | |
| 1573753 | Other | MS | CIGNA |
| 7636062 | Other | MS | AETNA |
| 876174 | Other | MS | HUMANA |
| 125360700 | Other | MS | AUDIOLOGY DEPT OF LABOR |
| 512I640002 | Other | MS | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1020 | MS | MD | Audiologist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Audiologist
- Diamondhead, MS
- NPI 1891900163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218585600000",
"number": "1073519211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5439 W ALOHA DR",
"address_2": "STE B",
"city": "DIAMONDHEAD",
"state": "MS",
"postal_code": "395253374",
"telephone_number": "228-255-8889",
"fax_number": "228-255-0890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5439 W ALOHA DR",
"address_2": "STE B",
"city": "DIAMONDHEAD",
"state": "MS",
"postal_code": "395253374",
"telephone_number": "228-255-8889",
"fax_number": "228-255-0890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "VIRGINIA",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "AUD CCC A SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-22",
"last_updated": "2008-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MS",
"license": "A1020",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S1020",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09015355",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1573753",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7636062",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "876174",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AUDIOLOGY DEPT OF LABOR",
"identifier": "125360700",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "512I640002",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Diamondhead, MS
- Amy Catherine Love Baggett, PHARMD
- Sarah E Barowka, M.D.
- Maria Casillas Barrett
- Bio-Medical Applications of Mississippi, Inc. (Fresenius Medical Care - SMKC - Diamondhead)
- Nicholas William Bondio, DO
- Brianna Rose Burchett
- Alma J Burrell, LCSW
- Lois Rose Calamusa
- Chamberlain Counseling Services LLC
- Cornelia Swayze, LCSW, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.