Active NPI
Deirdre Ann Worrell, MS
- Audiologist
- Hudson, WI
National Provider Identifier
1255325205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 454-156
- Practice address
- 1516 North Ridge Dr
Hudson, WI 54016-1879 - Phone
- (715) 386-1760
- NPI assigned
- Sep 6, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 | 454-156 | WI | Primary |
| Speech-Language Pathologist | 235Z00000X | 938-154 | WI |
Addresses
Primary practice location
1516 North Ridge Dr
Hudson, WI 54016-1879
Mailing address
1516 North Ridge Dr
Hudson, WI 54016-1879
Phone (715) 386-1760
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41149300 | Medicaid | WI | |
| 42567800 | Medicaid | WI |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 454-156 | WI | MD | Audiologist |
| 938-154 | WI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Ridge Hearing Co. LLC | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hearing Aid Equipment
- Hudson, WI
- NPI 1629507769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1255325205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 NORTH RIDGE DR",
"city": "HUDSON",
"state": "WI",
"postal_code": "540161879",
"telephone_number": "715-386-1760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 NORTH RIDGE DR",
"city": "HUDSON",
"state": "WI",
"postal_code": "540161879",
"telephone_number": "715-386-1760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORRELL",
"first_name": "DEIRDRE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-06",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WI",
"license": "454-156",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "938-154",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41149300",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42567800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.