Candace Utranusorn, AU.D., CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

81225 Issued in TX

Practice address

4106 Marathon Blvd Ste a
Austin, TX 78756-3746

Phone

(512) 407-9215

Fax

(512) 434-0154

NPI assigned

Jul 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illuminear Tinnitus and Audiology CenterGroup PAC ID 2567786049, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illuminear Tinnitus & Audiology Center

  dba IlluminEar Audiology

  • Audiologist
  • Austin, TX
  • NPI 1689076572
  Medicare reassignment Care Compare group NPD
• DCLC Enterprises, LLC

  • Audiologist
  • Cedar Park, TX
  • NPI 1427191014
  NPD

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1255958351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 MARATHON BLVD STE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563746",
            "telephone_number": "512-407-9215",
            "fax_number": "512-434-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 MARATHON BLVD STE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563746",
            "telephone_number": "512-407-9215",
            "fax_number": "512-434-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTRANUSORN",
        "first_name": "CANDACE",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Utah Lithotripsy, LP
• Utc Providers - Austin Inc (UTC Health & Rehab - Austin)
• Utilization Partners
• Utmb Austin - Initiatives
• Utmb Faculty Group Practice
• Stephen J Utts, M.D.
• Uvalde County Hospital Authority (Southwood Care Center)
• Dora Uvalle, B.S. SLPA
• Fortune Uwa-Ndukwe
• Joyee Uwange

• Audiologist in Austin, TX
• Providers in Austin, TX by specialty
• Audiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.