Individual provider Active NPI

Linda M Farley, MS CCCA

  • Audiologist
  • Hazleton, PA
National Provider Identifier
1194724468
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT000056L Issued in PA
Practice address
1523 N Church St
Hazleton, PA 18202
Phone
(570) 454-8404
Fax
(570) 454-8404
NPI assigned
Jul 19, 2005
Reactivated
Mar 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT000056L PA Primary

Addresses

Primary practice location

1523 N Church St
Hazleton, PA 18202

Mailing address

1523 N Church St
Hazleton, PA 18202
Phone (570) 454-8404

Other identifiers 2

IdentifierTypeStateIssuer
0014129200005MedicaidPA
207475OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000718 PA Practitioner - Qualified Audiologist 2466647615 Practice locations: Hazleton, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1194724468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 N CHURCH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-454-8404",
            "fax_number": "570-454-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 N CHURCH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-454-8404",
            "fax_number": "570-454-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "LINDA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MS CCCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-08-09",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT000056L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014129200005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "207475",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.