Individual provider Active NPI

Debra K Venkatesh, AU.D.

  • Assistive Technology Practitioner Audiologist
  • Tempe, AZ
National Provider Identifier
1144310541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistive Technology Practitioner AudiologistTaxonomy code 231HA2400X
License
DA1670 Issued in AZ
Practice address
2501 E Southern Ave
Suite 21
Tempe, AZ 85282-7669
Phone
(480) 833-4330
Fax
(480) 833-1902
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Practitioner Audiologist 231HA2400X DA1670 AZ Primary

Addresses

Primary practice location

2501 E Southern Ave
Suite 21
Tempe, AZ 85282-7669

Mailing address

2501 E Southern Ave
Suite 21
Tempe, AZ 85282-7669
Phone (480) 833-4330

Other identifiers 2

IdentifierTypeStateIssuer
0902100OtherAZBLUE CROSS BLUE SHIELD
470659OtherAZAHCCCS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115001155 AZ Practitioner - Qualified Audiologist 8921027277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Hearcare Network, Inc PastSince Jul 19, 2001 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144310541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E SOUTHERN AVE",
            "address_2": "SUITE 21",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827669",
            "telephone_number": "480-833-4330",
            "fax_number": "480-833-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E SOUTHERN AVE",
            "address_2": "SUITE 21",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827669",
            "telephone_number": "480-833-4330",
            "fax_number": "480-833-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATESH",
        "first_name": "DEBRA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "AZ",
            "license": "DA1670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0902100",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER NUMBER",
            "identifier": "470659",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

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.
  • 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.