Active NPI
Deborah R John, AU.D.
- Audiologist
- Bloomsburg, PA
National Provider Identifier
1114000510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AT000982L
- Practice address
- 400 E 2ND St
Centennial Hall
Bloomsburg, PA 17815-1301 - Phone
- (570) 389-5380
- Fax
- (570) 389-5022
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AT000982L | PA | Primary |
| Audiologist-Hearing Aid Fitter | 237600000X | AT000982L | PA | |
| Assistive Technology Practitioner Audiologist | 231HA2400X | AT000982L | PA | |
| Assistive Technology Supplier Audiologist | 231HA2500X | AT000982L | PA |
Addresses
Primary practice location
400 E 2ND St
Centennial Hall
Bloomsburg, PA 17815-1301
Mailing address
400 E 2ND St
Centennial Hall
Bloomsburg, PA 17815-1301
Phone (570) 389-5380
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0019429170001 | Medicaid | PA | |
| 50009519 | Other | PA | BLUE CROSS |
| 50218 | Other | PA | GEISINGER HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 E 2ND St
Bloomsburg, PA 17815-1301
Phone (570) 389-5380
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Husky Research Corporation Inc | Audiologist | Current | Accepting new patients |
| Bloomsburg University Speech & Hearing Clinic | Audiologist | Past | Accepting new patients |
Locations
400 E 2nd St
Bloomsburg, PA 17815
Phone (570) 389-4451
400 E 2nd St
#338
Bloomsburg, PA 17815
Phone (570) 389-4436
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.
-
- Audiologist
- Bloomsburg, PA
- NPI 1518040179
-
- Audiologist
- Bloomsburg, PA
- NPI 1558446468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1114000510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 2ND ST",
"address_2": "CENTENNIAL HALL",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178151301",
"telephone_number": "570-389-5380",
"fax_number": "570-389-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 2ND ST",
"address_2": "CENTENNIAL HALL",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178151301",
"telephone_number": "570-389-5380",
"fax_number": "570-389-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHN",
"first_name": "DEBORAH",
"middle_name": "R",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "PA",
"license": "AT000982L",
"primary": true
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "PA",
"license": "AT000982L",
"primary": false
},
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "PA",
"license": "AT000982L",
"primary": false
},
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "PA",
"license": "AT000982L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019429170001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "50009519",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "50218",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.