Individual provider Active NPI

Emma Chesnut, AU.D.

  • Audiologist
  • Clemmons, NC
National Provider Identifier
1215310081
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
11470 Issued in NC
Practice address
3780 Clemmons Rd Ste a
Clemmons, NC 27012-7515
Phone
(336) 766-2677
NPI assigned
Jun 29, 2015
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 11470 NC Primary

Addresses

Primary practice location

3780 Clemmons Rd Ste a
Clemmons, NC 27012-7515

Mailing address

3780 Clemmons Rd Ste a
Clemmons, NC 27012-7515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016001083 NC Practitioner - Qualified Audiologist 8820307788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
East Tennessee State University Quillen College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

106 W Medical Park Dr
Suite C
Lexington, NC 27292-6845
Phone (336) 249-3551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11470NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Apr 24, 2023 Accepting new patients
Hearing Clinic, Inc. PastSince Sep 27, 2021 Accepting new patients

Locations

624 Quaker Ln
Ste 208C
High Point, NC 27262
Phone (336) 781-4050

322 Mulberry St SW
Ste C
Lenoir, NC 28645
Phone (828) 757-6464

106 W Medical Park Dr
Ste C
Lexington, NC 27292
Phone (336) 249-3551

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1215310081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 CLEMMONS RD STE A",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270127515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 CLEMMONS RD STE A",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270127515",
            "telephone_number": "336-766-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESNUT",
        "first_name": "EMMA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "11470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.