Active NPI
Tera Marie Quigley, AU.D.
- Audiologist
- Bloomington, IN
National Provider Identifier
1134563513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 23002523A
- Practice address
- 200 S Jordan Ave
Bloomington, IN 47405-7002 - Phone
- (812) 856-1186
- NPI assigned
- Apr 29, 2013
- 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 | 23002523A | IN | Primary |
Addresses
Primary practice location
200 S Jordan Ave
Bloomington, IN 47405-7002
Mailing address
200 S Jordan Ave
Bloomington, IN 47405-7002
Phone (812) 856-1186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100276980A | Medicaid | IN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23002523A | IN | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367193600000",
"number": "1134563513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S JORDAN AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474057002",
"telephone_number": "812-856-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S JORDAN AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474057002",
"telephone_number": "812-856-1186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIGLEY",
"first_name": "TERA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-29",
"last_updated": "2013-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IN",
"license": "23002523A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100276980A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.