Individual provider Active NPI

Dale Ladonn Egbert

  • Hearing Instrument Specialist
  • Paducah, KY
National Provider Identifier
1245819184
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
242181 Issued in KY
Practice address
4793 Village Square Dr # 140
Paducah, KY 42001-7435
Phone
(270) 444-0448
Fax
(270) 444-0449
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 242181 KY Primary

Addresses

Primary practice location

4793 Village Square Dr # 140
Paducah, KY 42001-7435

Mailing address

131 Enterprise Rd
Johnstown, NY 12095-3326
Phone (401) 353-4174

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
242181KYMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1245819184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ENTERPRISE RD",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120953326",
            "telephone_number": "401-353-4174",
            "fax_number": "401-488-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4793 VILLAGE SQUARE DR # 140",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017435",
            "telephone_number": "270-444-0448",
            "fax_number": "270-444-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "DALE",
        "middle_name": "LADONN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "KY",
            "license": "242181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.