Individual provider Active NPI

Bethany Tucker, AU.D.

  • Audiologist
  • Williamsburg, VA
National Provider Identifier
1154748887
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1823 Issued in FL
Practice address
430 McLaws Cir
Suite 101
Williamsburg, VA 23185-5655
Phone
(757) 229-4004
Fax
(757) 229-9992
NPI assigned
Mar 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY1823 FL Primary

Addresses

Primary practice location

430 McLaws Cir
Suite 101
Williamsburg, VA 23185-5655

Mailing address

430 McLaws Cir
Suite 101
Williamsburg, VA 23185-5655
Phone (757) 229-4004

Other names 1

  • Bethany Magee Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150113002403 VA Practitioner - Qualified Audiologist 2668796012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY1823FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vertigo Dizzy Clinic LLC Audiologist CurrentSince Nov 17, 2014 Accepting new patients
Colonial Center for Hearing Inc Audiologist CurrentSince Nov 17, 2014 Accepting new patients
Hampton Roads Otolaryngology Associates PLLC Past Accepting new patients

Locations

430 McLaws Cir
Ste 101
Williamsburg, VA 23185
Phone (757) 229-4004

Organizations & group practices 3

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": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1154748887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MCLAWS CIR",
            "address_2": "SUITE 101",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855655",
            "telephone_number": "757-229-4004",
            "fax_number": "757-229-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MCLAWS CIR",
            "address_2": "SUITE 101",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855655",
            "telephone_number": "757-229-4004",
            "fax_number": "757-229-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BETHANY",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "MAGEE",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.