NPIMap

Organization Active NPI

West Tennessee Hearing & Speech Center, Inc

  • Hearing and Speech Clinic/Center
  • Jackson, TN
National Provider Identifier
1194904342
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
License
0000002395 Issued in TN
Legal business name
WEST TENNESSEE HEARING & SPEECH CENTER, INC
Practice address
65 Ridgecrest Rd
Jackson, TN 38305-2359
Phone
(731) 668-6076
Fax
(731) 668-7033
NPI assigned
Oct 24, 2007
Organization subpart
No

Practitioners 12

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091113000282 TN Part B Supplier - Clinic/Group Practice 8729126610 Receives reassigned benefits from 4 practitioners
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory

Locations

65 Ridgecrest Rd
Jackson, TN 38305
Phone (731) 446-5441

213 E Lafayette St
Jackson, TN 38301
Phone (731) 554-1033

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Authorized official

Name
Kimberli Moore, MS, CCC-SLPNPI 1134231400
Title
Executive Director
Phone
(731) 668-6076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X 0000002395 TN Primary

Addresses

Primary practice location

65 Ridgecrest Rd
Jackson, TN 38305-2359

Mailing address

65 Ridgecrest Rd
Jackson, TN 38305-2359
Phone (731) 668-6076

Other identifiers 1

IdentifierTypeStateIssuer
3530285MedicaidTN

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1194904342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 RIDGECREST RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052359",
            "telephone_number": "731-668-6076",
            "fax_number": "731-668-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 RIDGECREST RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052359",
            "telephone_number": "731-668-6076",
            "fax_number": "731-668-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TENNESSEE HEARING & SPEECH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KIMBERLI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-668-6076",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "TN",
            "license": "0000002395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3530285",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.