Greater Portland Hearing PC

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

AP1251 Issued in ME

Legal business name

GREATER PORTLAND HEARING PC

Practice address

163 Main St
Yarmouth, ME 04096-6720

Phone

(207) 846-1380

Fax

(207) 846-9701

NPI assigned

Oct 8, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kristie A Iacuessa, AU.D.NPI 1063586907

Title

Owner, Audiologist

Phone

(207) 846-1380

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Yarmouth Audiology Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Practitioners 2

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

• Kristie A Iacuessa, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Yarmouth, ME
  • NPI 1063586907
  Medicare reassignment Care Compare group NPD Authorized official
• Krista Linne Riccioni, MA

  • Audiologist
  • Topsham, ME
  • NPI 1467019893
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1194077602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966720",
            "telephone_number": "207-846-1380",
            "fax_number": "207-846-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966720",
            "telephone_number": "207-846-1380",
            "fax_number": "207-846-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER PORTLAND HEARING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "IACUESSA",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER, AUDIOLOGIST",
        "authorized_official_telephone_number": "207-846-1380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "ME",
            "license": "AP1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063586907",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274460099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yarmouth Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Michael Glocke, D.C.
• Amy Good, RD, LD
• Peter T Gordon, MD
• Jana Marie Grant, OTR/L
• Allison Gray, FNP
• Amy Taylor Grimm, RDN
• Barrett Grimnes, PA-C
• Ann Hollinger Grogan, L.C.S.W.
• Hayle Grover
• Norman J Guay III, D.O.

• Audiologist-Hearing Aid Fitter in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Audiologist-Hearing Aid Fitter in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.