Organization Active NPI

Nelson Audiology PLLC

  • Audiologist
  • Litchfield, IL
National Provider Identifier
1154094340
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
NELSON AUDIOLOGY PLLC
Practice address
220 E Ryder St
Litchfield, IL 62056-2033
Phone
(217) 324-2433
Fax
(217) 324-3377
NPI assigned
Jul 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Deanna Marie Boston, AUDNPI 1720130065
Title
Audilogist
Phone
(217) 324-2433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

220 E Ryder St
Litchfield, IL 62056-2033

Mailing address

220 E Ryder St
Litchfield, IL 62056-2033
Phone (217) 324-2433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211203000244 IL Part B Supplier - Clinic/Group Practice 6305236464 Receives reassigned benefits from 1 practitioner
Practice locations: Litchfield, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1154094340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E RYDER ST",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620562033",
            "telephone_number": "217-324-2433",
            "fax_number": "217-324-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E RYDER ST",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620562033",
            "telephone_number": "217-324-2433",
            "fax_number": "217-324-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON AUDIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "BOSTON",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "AUDILOGIST",
        "authorized_official_telephone_number": "217-324-2433",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.