Fort Wayne Audiology Consultants, LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

License

23002551A Issued in IN

Legal business name

FORT WAYNE AUDIOLOGY CONSULTANTS, LLC

Practice address

4720 E State Blvd
Fort Wayne, IN 46815-6923

Phone

(260) 471-5693

Fax

(260) 471-4942

NPI assigned

May 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Zachary Burkle, AUD

Title

Audiologist/Owner

Phone

(317) 616-8048

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lowe Audiology and Hearing Care Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sergio R Gonzalez Mansilla, HAD

  • Hearing Instrument Specialist
  • Fort Wayne, IN
  • NPI 1568256931
  NPD (past)
• Ashleigh Gressley

  • Hearing Instrument Specialist
  • Fort Wayne, IN
  • NPI 1205474103
  NPD (past)
• Richard Gregory Lowe, PH.D., AU.D.

  • Audiologist
  • Fort Wayne, IN
  • NPI 1700850518
  NPD (past)

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1104237916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156923",
            "telephone_number": "260-471-5693",
            "fax_number": "260-471-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156923",
            "telephone_number": "260-471-5693",
            "fax_number": "260-471-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE AUDIOLOGY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "BURKLE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ZACHARY",
        "authorized_official_title_or_position": "AUDIOLOGIST/OWNER",
        "authorized_official_telephone_number": "317-616-8048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "IN",
            "license": "23002551A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201255480 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lowe Audiology and Hearing Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hearing and Speech Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Hearing and Speech Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.

Verify at the official NPI Registry.