Ball State University

Primary specialty

AudiologistTaxonomy code 231H00000X

License

23002219A Issued in IN

Legal business name

BALL STATE UNIVERSITY

Doing business as

Interprofessional Community Clinics

Practice address

1613 W Riverside Ave HB 155
Muncie, IN 47306-1022

Phone

(765) 285-5354

Fax

(765) 285-5623

NPI assigned

May 3, 2007

Last updated

Dec 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Blair Scott MatternNPI 1205156155

Title

Dir of Clinical Operations

Phone

(765) 285-5354

Specialties & licenses 15

Addresses

Other names 1

• Interprofessional Community Clinics Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Tax ID family

Ball Sate University3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ball State University

  dba Ball State Sports Medicine

  • Primary Care Nurse Practitioner
  • Muncie, IN
  • NPI 1295137925
  NPD tax ID
• Burris Laboratory School

  • Local Education Agency (LEA)
  • Muncie, IN
  • NPI 1407984107
  NPD tax ID

Locations

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Blair Scott Mattern, AU.D.

  • Audiologist
  • Muncie, IN
  • NPI 1205156155
  Medicare reassignment Care Compare group NPD Authorized official
• Madison Paige Bauer, CCC-SLP

  • Speech-Language Pathologist
  • Carmel, IN
  • NPI 1528727609
  Medicare reassignment Care Compare group NPD
• April Dawn Condon, CCC-SLP

  • Speech-Language Pathologist
  • Muncie, IN
  • NPI 1588697577
  Medicare reassignment Care Compare group NPD
• Laura Lea Fragomeni, AU.D.

  • Audiologist
  • Indianapolis, IN
  • NPI 1750531950
  Medicare reassignment Care Compare group NPD
• Rebecca Kadinger, SLP

  • Speech-Language Pathologist
  • Muncie, IN
  • NPI 1255458006
  Medicare reassignment Care Compare group NPD
• Kara Landis, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Indianapolis, IN
  • NPI 1790807105
  Medicare reassignment Care Compare group NPD
• Gregory Marshall Newman, M.A.

  • Audiologist-Hearing Aid Fitter
  • Muncie, IN
  • NPI 1740586569
  Medicare reassignment Care Compare group NPD
• Laura G Stevenson, AUDIOLOGIST

  • Audiologist
  • Muncie, IN
  • NPI 1588983183
  Medicare reassignment Care Compare group NPD
• Yi-Hsin Tai, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Santa Maria, CA
  • NPI 1265749329

  IN

  Medicare reassignment Care Compare group NPD
• Carlye H McLaughlin

  • Speech-Language Pathologist
  • Fort Wayne, IN
  • NPI 1467927400
  Medicare reassignment Care Compare group
• Hilary Ann Eppert, MA, CCC-A

  • Audiologist
  • Anderson, IN
  • NPI 1659546869
  Medicare reassignment NPD
• Mary J Ewing, SLP

  • Speech-Language Pathologist
  • Carmel, IN
  • NPI 1619025210
  Medicare reassignment NPD

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1093937476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 W RIVERSIDE AVE HB 155",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473061022",
            "telephone_number": "765-285-5354",
            "fax_number": "765-285-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 W RIVERSIDE AVE HB 155",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473061022",
            "telephone_number": "765-285-5354",
            "fax_number": "765-285-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALL STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "MATTERN",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DIR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "765-285-5354"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002219A",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002244A",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23000144",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002284A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002106",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22000224A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22001549",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002004A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003906A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002254A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003456A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22001560",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22001905A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002571",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22001890A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interprofessional Community Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Bales
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• Ball State Healthcenter Pharmacy
• Ball State University (Ball State Sports Medicine)
• Carrie Ball, PH.D.
• Catherine C Ballard, LMHC
• Julia Renee Ballard
• Samuel Ryan Balle

• Audiologist in Muncie, IN
• Providers in Muncie, IN by specialty
• Audiologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.