Organization Active NPI

Hearcare Connection, Inc.

  • Audiologist
  • Fort Wayne, IN
National Provider Identifier
1174899405
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
HEARCARE CONNECTION, INC.
Practice address
130 W Main St Ste 150
Fort Wayne, IN 46802
Phone
(260) 602-3276
Fax
(260) 444-3656
NPI assigned
Mar 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Authorized official

Name
Anna Bogdon
Title
Executive Director
Phone
(260) 602-3276

Specialties & licenses 1

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

Addresses

Primary practice location

130 W Main St Ste 150
Fort Wayne, IN 46802

Mailing address

130 W Main St Ste 150
Fort Wayne, IN 46802-1712
Phone (260) 602-3276

Other identifiers 1

IdentifierTypeStateIssuer
201061520AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140131001973 IN Part B Supplier - Clinic/Group Practice 8325277882 Receives reassigned benefits from 4 practitioners
Practice locations: Goshen, IN; Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

130 W Main St
Ste 150
Fort Wayne, IN 46802
Phone (260) 602-3276

Practitioners & affiliated clinicians

Practitioners 5

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": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1174899405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W MAIN ST STE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021712",
            "telephone_number": "260-602-3276",
            "fax_number": "260-444-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W MAIN ST STE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46802",
            "telephone_number": "260-602-3276",
            "fax_number": "260-444-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARCARE CONNECTION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "BOGDON",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "260-602-3276"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201061520A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.