Active NPI
Kelly Correll, BCHIS
- Hearing Instrument Specialist
- Cheyenne, WY
National Provider Identifier
1093266587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 142
- Practice address
- 3001 Henderson Dr
Suite K
Cheyenne, WY 82001-5840 - Phone
- (307) 634-7550
- Fax
- (307) 634-4463
- NPI assigned
- Oct 19, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 698 | NE | |
| Hearing Instrument Specialist | 237700000X | 142 | WY | Primary |
| Hearing Instrument Specialist | 237700000X | 429H | SD |
Addresses
Primary practice location
3001 Henderson Dr
Suite K
Cheyenne, WY 82001-5840
Mailing address
3001 Henderson Dr
Suite K
Cheyenne, WY 82001-5840
Phone (307) 634-7550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124021800 | Medicaid | WY |
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 |
|---|---|---|---|
| 142 | WY | MD | Pediatric Physical Therapist |
| 429H | SD | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millers Hearing Aid Centers Inc | Hearing Instrument Specialist | Past | 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.
-
- Hearing Instrument Specialist
- Cheyenne, WY
- NPI 1356477095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476835200000",
"number": "1093266587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 HENDERSON DR",
"address_2": "SUITE K",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820015840",
"telephone_number": "307-634-7550",
"fax_number": "307-634-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 HENDERSON DR",
"address_2": "SUITE K",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820015840",
"telephone_number": "307-634-7550",
"fax_number": "307-634-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORRELL",
"first_name": "KELLY",
"credential": "BCHIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-19",
"last_updated": "2016-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "NE",
"license": "698",
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WY",
"license": "142",
"primary": true
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "SD",
"license": "429H",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124021800",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.