Active NPI
Pamela Jo Feehan, AUD CCCA
- Audiologist
- Rapid City, SD
National Provider Identifier
1114012176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 007A
- Practice address
- 30 Knollwood Dr
Suite C
Rapid City, SD 57701-0695 - Phone
- (605) 348-7706
- Fax
- (605) 716-2614
- NPI assigned
- Oct 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 007A | SD | Primary |
Addresses
Primary practice location
30 Knollwood Dr
Suite C
Rapid City, SD 57701-0695
Mailing address
PO Box 8475
Rapid City, SD 57709-8475
Phone (605) 348-7706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5834250 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007A | SD | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114012176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8475",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577098475",
"telephone_number": "605-348-7706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 KNOLLWOOD DR",
"address_2": "SUITE C",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577010695",
"telephone_number": "605-348-7706",
"fax_number": "605-716-2614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEEHAN",
"first_name": "PAMELA",
"middle_name": "JO",
"credential": "AUD CCCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "SD",
"license": "007A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5834250",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.