Active NPI
East Central Audiology, LTD
- Audiologist
- Forest Lake, MN
National Provider Identifier
1124183314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 6007
- Legal business name
- EAST CENTRAL AUDIOLOGY, LTD
- Practice address
- 1068 Lake St S
Suite 108
Forest Lake, MN 55025-2639 - Phone
- (651) 464-8486
- Fax
- (651) 464-8747
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Julie Ann Perreault, AUDIOLOGIST
- Title
- Ceo
- Phone
- (651) 464-8486
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 6007 | MN | Primary |
Addresses
Primary practice location
1068 Lake St S
Suite 108
Forest Lake, MN 55025-2639
Mailing address
1068 Lake St S
Suite 108
Forest Lake, MN 55025-2639
Phone (651) 464-8486
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114370 | Other | MN | UCARE |
| 41394 | Other | MN | HEALTHPARTNERS |
| 1011302 | Other | MN | PERFERRED ONE |
| 5G979EA | Other | MN | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
1068 Lake St S
Ste 108
Forest Lake, MN 55025
Phone (651) 464-8486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1124183314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1068 LAKE ST S",
"address_2": "SUITE 108",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252639",
"telephone_number": "651-464-8486",
"fax_number": "651-464-8747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1068 LAKE ST S",
"address_2": "SUITE 108",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252639",
"telephone_number": "651-464-8486",
"fax_number": "651-464-8747"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST CENTRAL AUDIOLOGY, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PERREAULT",
"authorized_official_first_name": "JULIE",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "651-464-8486",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "AUDIOLOGIST"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Audiologist",
"state": "MN",
"license": "6007",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "114370",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "41394",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERFERRED ONE",
"identifier": "1011302",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5G979EA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.