Active NPI
Elizabeth Stratford Fallon, AU.D., FAAA
- Audiologist
- Fort Sam Houston, TX
National Provider Identifier
1215093828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 80583
- Practice address
- 3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504 - Phone
- (210) 539-9582
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5003 | NC | |
| Audiologist | 231H00000X | 80583 | TX | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Other practice location 1
703 Bryant St
Statesville, NC 28677-4142
Phone (704) 872-1670
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
| License | State | Type | Specialty |
|---|---|---|---|
| 80583 | TX | MD | Mental Health Counselor |
| 5003 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Hearing and Tinnitus, PC | Past | Accepting new patients | |
| Hearing Services & Hearing Aid Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Hearing Aid Equipment
- Mooresville, NC
- NPI 1346775244
-
- Audiologist-Hearing Aid Fitter
- Statesville, NC
- NPI 1114009370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1215093828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-539-9582"
}
],
"practiceLocations": [
{
"address_1": "703 Bryant St",
"address_purpose": "LOCATION",
"city": "Statesville",
"state": "NC",
"postal_code": "286774142",
"country_code": "US",
"telephone_number": "704-872-1670",
"fax_number": "704-878-6600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FALLON",
"first_name": "ELIZABETH",
"middle_name": "STRATFORD",
"name_prefix": "Dr.",
"credential": "AU.D., FAAA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NC",
"license": "5003",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "80583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.