Active NPI
Tina Wallace Easterling, AU.D.
- Audiologist
- Fayetteville, NC
National Provider Identifier
1073862686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 4360
- Practice address
- 7300 South Raeford Road
VA Fayetteville Health Care Center / Audiology
Fayetteville, NC 28304 - Phone
- (910) 488-2120
- NPI assigned
- Aug 29, 2012
- Last updated
- Feb 22, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4360 | NC | Primary |
Addresses
Primary practice location
7300 South Raeford Road
VA Fayetteville Health Care Center / Audiology
Fayetteville, NC 28304
Mailing address
7300 South Raeford Road
VA Fayetteville Health Care Center / Audiology
Fayetteville, NC 28304
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4360 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1073862686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 SOUTH RAEFORD ROAD",
"address_2": "VA FAYETTEVILLE HEALTH CARE CENTER / AUDIOLOGY",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 SOUTH RAEFORD ROAD",
"address_2": "VA FAYETTEVILLE HEALTH CARE CENTER / AUDIOLOGY",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28304",
"telephone_number": "910-488-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTERLING",
"first_name": "TINA",
"middle_name": "WALLACE",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NC",
"license": "4360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.