Individual provider Active NPI

Lisa Baer

  • Audiologist-Hearing Aid Fitter
  • Bloomington, IL
National Provider Identifier
1083626485
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
Practice address
1404 Eastland Dr Ste 209
Bloomington, IL 61701-7904
Phone
(309) 662-3277
Fax
(309) 663-0845
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X IL
Audiologist-Hearing Aid Fitter 237600000X IL Primary

Addresses

Primary practice location

1404 Eastland Dr Ste 209
Bloomington, IL 61701-7904

Mailing address

1404 Eastland Dr Ste 209
Bloomington, IL 61701-7904
Phone (309) 662-3277

Other identifiers 1

IdentifierTypeStateIssuer
05700224OtherBLUE CROSS BLUE SHIELD

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
147.001116ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomington Normal Ear Nose Throat LTD Audiologist PastSince Jul 9, 2010 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083626485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DR STE 209",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017904",
            "telephone_number": "309-662-3277",
            "fax_number": "309-663-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DR STE 209",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017904",
            "telephone_number": "309-662-3277",
            "fax_number": "309-663-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAER",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05700224",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.