Individual provider Active NPI

Kelly Lynn Pullman, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Mesa, AZ
National Provider Identifier
1225451495
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
DA8695 Issued in AZ
Practice address
1840 S Stapley Dr Ste 101
Mesa, AZ 85204-6682
Phone
(480) 464-6870
NPI assigned
Jan 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X DA8695 AZ Primary

Addresses

Primary practice location

1840 S Stapley Dr Ste 101
Mesa, AZ 85204-6682

Mailing address

1840 S Stapley Dr Ste 101
Mesa, AZ 85204-6682
Phone (480) 464-6870

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

LicenseStateTypeSpecialty
DA8695AZMDAudiologist-Hearing Aid Fitter

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1225451495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 S STAPLEY DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046682",
            "telephone_number": "480-464-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 S STAPLEY DR STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046682",
            "telephone_number": "480-464-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLMAN",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA8695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.