Individual provider Active NPI

Kristine Louise Landenberger, M.A., CCC/A

  • Audiologist
  • Canton, OH
National Provider Identifier
1104916360
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-00699 Issued in OH
Practice address
4912 Higbee Ave NW
Suite #200
Canton, OH 44718-2530
Phone
(330) 492-2844
Fax
(330) 492-0840
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-00699 OH Primary

Addresses

Primary practice location

4912 Higbee Ave NW
Suite #200
Canton, OH 44718-2530

Mailing address

4912 Higbee Ave NW
Suite #200
Canton, OH 44718-2530
Phone (330) 492-2844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000448 OH Practitioner - Qualified Audiologist 5597816777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Head and Neck Surgeons, IncGroup PAC ID 2860426376, 10 clinicians

Practice addresses (Care Compare)

4912 Higbee Ave NW
Canton, OH 44718-2599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A-00699OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Head and Neck Surgeons, Inc CurrentSince May 11, 2009 Accepting new patients
Union Hospital Medical Services, LLC Past Accepting new patients

Locations

4912 Higbee Ave NW
Ste 200
Canton, OH 44718
Phone (330) 492-2844

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1104916360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 HIGBEE AVE NW",
            "address_2": "SUITE #200",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182530",
            "telephone_number": "330-492-2844",
            "fax_number": "330-492-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 HIGBEE AVE NW",
            "address_2": "SUITE #200",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182530",
            "telephone_number": "330-492-2844",
            "fax_number": "330-492-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDENBERGER",
        "first_name": "KRISTINE",
        "middle_name": "LOUISE",
        "credential": "M.A., CCC/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-00699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.