Kathryn Merry Tiedy, M.S., CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

000502 Issued in CT

Practice address

438 Main St
Suite 204
Middletown, CT 06457-3396

Phone

(888) 964-6681

Fax

(888) 662-0859

NPI assigned

Sep 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathryn Jean Merry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1114353802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 WORCESTER ST",
            "address_2": "SUITE 130",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823744",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 MAIN ST",
            "address_2": "SUITE 204",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573396",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDY",
        "first_name": "KATHRYN",
        "middle_name": "MERRY",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MERRY",
            "middle_name": "JEAN",
            "credential": "M.S., CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Audiologist in Middletown, CT
• Providers in Middletown, CT by specialty
• Audiologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.