Kelly Mankin Anderson, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

030899 Issued in OR

Practice address

780 NW York Dr Ste 102
Bend, OR 97703-1054

Phone

(541) 280-7548

Fax

(541) 904-8378

NPI assigned

Apr 22, 2020

Last updated

Oct 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ekho Audiology LLC

  • Audiologist
  • Bend, OR
  • NPI 1760250294
  Medicare reassignment NPD Authorized official
• Hearing Doctor 2U LLC

  • Audiologist
  • Conway, SC
  • NPI 1184981425
  NPD
• Matthew S. Murphy

  dba House of Hearing Audiology Clinic

  • Audiologist-Hearing Aid Fitter
  • Boise, ID
  • NPI 1538816913
  NPD
• Biogenx Medical

  dba Coast to Coast Medical

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Glendora, CA
  • NPI 1962912246
  NPD (past)

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1083234710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 NW YORK DR STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031054",
            "telephone_number": "541-280-7548",
            "fax_number": "541-904-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NW YORK DR STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031054",
            "telephone_number": "541-280-7548",
            "fax_number": "541-904-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLY",
        "middle_name": "MANKIN",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "030899",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Rand Anderson
• Jordan Anderson, PHARMD
• Judith Meagan Anderson
• Karyn Anderson, FNP
• Katherine Anderson, DACM, LAC
• Lisa Elizabeth Anderson
• Martika Anderson, LMT
• Matthew Anderson, DDS
• Sarah Joann Anderson
• Scott Draper Anderson

• Audiologist in Bend, OR
• Providers in Bend, OR by specialty
• Audiologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.