Individual provider Active NPI

Meghan Kathleen Jensen, AU.D.

  • Audiologist
  • Fort Mill, SC
National Provider Identifier
1255484549
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4055 Issued in SC
Practice address
870 Gold Hill Rd
Suite 104
Fort Mill, SC 29708-8985
Phone
(803) 620-8250
Fax
(803) 638-6901
NPI assigned
Jan 19, 2007
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 6624 NC
Audiologist 231H00000X 4055 SC Primary
Audiologist-Hearing Aid Fitter 237600000X 4055 SC
Audiologist-Hearing Aid Fitter 237600000X 6624 NC

Addresses

Primary practice location

870 Gold Hill Rd
Suite 104
Fort Mill, SC 29708-8985

Mailing address

870 Gold Hill Rd
#104
Fort Mill, SC 29708-8985
Phone (803) 620-8250

Other identifiers 1

IdentifierTypeStateIssuer
SA1690MedicaidSC

Other names 1

  • Ms. Meghan Kathleen Drexel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080926000208 NC Practitioner - Qualified Audiologist 9931276383 Reassigns benefits to 1 organization
I20170413000364 SC Practitioner - Qualified Audiologist 9931276383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Audiology LLCGroup PAC ID 3870812159, 3 clinicians

Practice addresses (Care Compare)

870 Gold Hill Rd
Suite 104
Fort Mill, SC 29708-8988
Phone (803) 620-8250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6624NCMDMental Health Counselor
4055SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Audiology LLC Audiologist CurrentSince Jan 17, 2017 Accepting new patients
Cornerstone Ear Nose & Throat PA CurrentSince Aug 20, 2008 Accepting new patients
Lakeside Audiology LLC Audiologist-Hearing Aid Fitter Past Accepting new patients
Cornerstone Ear Nose & Throat PA PastSince Mar 19, 2023 Accepting new patients

Locations

1107 Reynolds St
Monroe, NC 28112
Phone (704) 289-8220

870 Gold Hill Rd
Ste 104
Fort Mill, SC 29708
Phone (803) 620-8250

Organizations & group practices 4

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1255484549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 GOLD HILL RD",
            "address_2": "#104",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088985",
            "telephone_number": "803-620-8250",
            "fax_number": "803-638-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 GOLD HILL RD",
            "address_2": "SUITE 104",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088985",
            "telephone_number": "803-620-8250",
            "fax_number": "803-638-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "MEGHAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "6624",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "4055",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "SC",
            "license": "4055",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NC",
            "license": "6624",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA1690",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGHAN",
            "last_name": "DREXEL",
            "middle_name": "KATHLEEN",
            "prefix": "MS.",
            "credential": "CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.