NPIMap

Organization Active NPI

Equistat LLC

  • Audiologist
  • Shelby, NC
National Provider Identifier
1073575486
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
EQUISTAT LLC
Practice address
1403 N Lafayette St
Shelby, NC 28150-3406
Phone
(704) 482-1447
Fax
(704) 481-9744
NPI assigned
Apr 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Authorized official

Name
Lamar L Young, PH.D.NPI 1265494967
Title
Clinical Director
Phone
(704) 482-1447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

1403 N Lafayette St
Shelby, NC 28150-3406

Mailing address

1403 N Lafayette St
Shelby, NC 28150-3406
Phone (704) 482-1447

Other identifiers 1

IdentifierTypeStateIssuer
89014G5MedicaidNC

National Provider Directory

National Provider Directory

Locations

1403 N Lafayette St
Shelby, NC 28150
Phone (704) 482-1447

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1073575486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 N LAFAYETTE ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503406",
            "telephone_number": "704-482-1447",
            "fax_number": "704-481-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 N LAFAYETTE ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503406",
            "telephone_number": "704-482-1447",
            "fax_number": "704-481-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUISTAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LAMAR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "704-482-1447",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014G5",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.