Organization Active NPI

Union Professional Hearing Center, LLC

  • Audiologist
  • Union, MO
National Provider Identifier
1265754279
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2002021117 Issued in MO
Legal business name
UNION PROFESSIONAL HEARING CENTER, LLC
Practice address
427 Jane Ave
Union, MO 63084-1907
Phone
(636) 583-4902
Fax
(636) 583-4925
NPI assigned
Feb 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Cynthia A Modrosic, M.S., F-AAANPI 1801068077
Title
Audiologist
Phone
(636) 583-4902

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 2002021117 MO Primary

Addresses

Primary practice location

427 Jane Ave
Union, MO 63084-1907

Mailing address

427 Jane Ave
Union, MO 63084-1907
Phone (636) 583-4902

Other names 1

  • Professional Hearing Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100625000201 MO Part B Supplier - Clinic/Group Practice 5496886061 Receives reassigned benefits from 1 practitioner
Practice locations: Union, MO

National Provider Directory

National Provider Directory

Locations

102 N Church St
Union, MO 63084
Phone (314) 583-4902

427 Jane Ave
Union, MO 63084
Phone (636) 583-4902

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1265754279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 JANE AVE",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630841907",
            "telephone_number": "636-583-4902",
            "fax_number": "636-583-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 JANE AVE",
            "city": "UNION",
            "state": "MO",
            "postal_code": "630841907",
            "telephone_number": "636-583-4902",
            "fax_number": "636-583-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION PROFESSIONAL HEARING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "MODROSIC",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "636-583-4902",
        "authorized_official_credential": "M.S., F-AAA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2002021117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Hearing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.