Individual provider Active NPI

Laurie K Oberg, AUDIOLOGIST

  • Audiologist
  • Sandy, UT
National Provider Identifier
1093937864
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
373028-4101 Issued in UT
Practice address
9361 S 300 E
Sandy, UT 84070-2902
Phone
(801) 826-5000
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 373028-4101 UT Primary

Addresses

Primary practice location

9361 S 300 E
Sandy, UT 84070-2902

Mailing address

149 W 4050 N
Pleasant View, UT 84414-2739
Phone (801) 592-8109

Other identifiers 1

IdentifierTypeStateIssuer
999000021033MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250425000213 TX Practitioner - Qualified Audiologist 5193241891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

103 Medicine Way Rd
Peridot, AZ 85542-0787
Phone (928) 475-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
373028-4101UTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Mar 17, 2025 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1093937864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 W 4050 N",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844142739",
            "telephone_number": "801-592-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9361 S 300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702902",
            "telephone_number": "801-826-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERG",
        "first_name": "LAURIE",
        "middle_name": "K",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "373028-4101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999000021033",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.