Modern Tinnitus LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

MODERN TINNITUS LLC

Practice address

1717 E Morten Ave Unit 10
Phoenix, AZ 85020-4752

Phone

(636) 219-1353

NPI assigned

May 29, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Ashley D. Olson

Title

Member

Phone

(636) 219-9635

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1104666098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E MORTEN AVE UNIT 10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204752",
            "telephone_number": "636-219-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E MORTEN AVE UNIT 10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204752",
            "telephone_number": "636-219-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN TINNITUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "636-219-9635",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing and Speech Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Hearing and Speech Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.