Dixie Hearing and Balance Center Inc.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

59355224101 Issued in UT

Legal business name

DIXIE HEARING AND BALANCE CENTER INC.

Practice address

1301 Bertha Howe Ave Ste 6
Mesquite, NV 89027-7503

Phone

(435) 688-8991

Fax

(435) 688-2122

NPI assigned

Sep 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Layne Luekenga Jr., AU.D.

Title

President

Phone

(435) 688-8991

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Dixie Hearing & Balance Center

  • Audiologist
  • St George, UT
  • NPI 1902087547

  O20070926000585

  Same enrollment

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

• Barrett Victor St George, AUD, PHD

  • Audiologist
  • St George, UT
  • NPI 1669191557
  NPD (past)
• Ryan Michael Whitaker, AU.D

  • Audiologist
  • St. George, UT
  • NPI 1437461456
  NPD (past)

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1114112992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 400 E STE 103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703765",
            "telephone_number": "435-688-8991",
            "fax_number": "435-688-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BERTHA HOWE AVE STE 6",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890277503",
            "telephone_number": "435-688-8991",
            "fax_number": "435-688-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE HEARING AND BALANCE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "LUEKENGA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-688-8991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "UT",
            "license": "59355224101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D6362",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mesquite, NV
• Audiologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.