Individual provider Active NPI

Anna Grace Weasenforth, AUD

  • Audiologist
  • Indianapolis, IN
National Provider Identifier
1164831848
Registry record updated Dec 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002589A Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 944-8868
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002589A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 944-8868

Other identifiers 3

IdentifierTypeStateIssuer
188JSOtherNCBCBS
Q47704AOtherNCMEDICARE
SAN121MedicaidSC

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

LicenseStateTypeSpecialty
4312OKMDChiropractor
11075NCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC Past 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": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513900800000",
    "number": "1164831848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEASENFORTH",
        "first_name": "ANNA",
        "middle_name": "GRACE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2017-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002589A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "188JS",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q47704A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SAN121",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.