Individual provider Active NPI

Audra N. Branham, AU.D.

  • Audiologist
  • Boardman, OH
National Provider Identifier
1225342090
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.01753 Issued in OH
Practice address
755 Boardman Canfield Rd
South Bridge West, C1
Boardman, OH 44512-4300
Phone
(330) 726-8155
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A.01753 OH Primary
Assistive Technology Practitioner Audiologist 231HA2400X A.01753 OH
Assistive Technology Supplier Audiologist 231HA2500X A.01753 OH
Audiologist-Hearing Aid Fitter 237600000X A.01753 OH

Addresses

Primary practice location

755 Boardman Canfield Rd
South Bridge West, C1
Boardman, OH 44512-4300

Mailing address

755 Boardman Canfield Rd
South Bridge West, C1
Boardman, OH 44512-4300
Phone (330) 726-8155

Other identifiers 1

IdentifierTypeStateIssuer
0516301MedicaidOH

Other names 1

  • Dr. Audra N. Brooks Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000227 OH Practitioner - Qualified Audiologist 5294907812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A.01753OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuro-Communication Services, Inc. Audiologist Current Accepting new patients

Locations

755 Boardman Canfield Rd
Ste C1
Youngstown, OH 44512
Phone (330) 726-8155

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1225342090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "SOUTH BRIDGE WEST, C1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-726-8155",
            "fax_number": "330-726-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "SOUTH BRIDGE WEST, C1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-726-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANHAM",
        "first_name": "AUDRA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.01753",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "OH",
            "license": "A.01753",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "OH",
            "license": "A.01753",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OH",
            "license": "A.01753",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0516301",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDRA",
            "last_name": "BROOKS",
            "middle_name": "N.",
            "prefix": "DR.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.