Active NPI
Sara Beth Harnack, AUD
- Audiologist
- Waterloo, IA
National Provider Identifier
1285722041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 00467
- Practice address
- 1753 W Ridgeway Ave
Suite 111
Waterloo, IA 50701-4588 - Phone
- (319) 833-5970
- Fax
- (319) 833-5971
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 00467 | IA | Primary |
Addresses
Primary practice location
1753 W Ridgeway Ave
Suite 111
Waterloo, IA 50701-4588
Mailing address
PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0487157 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00467 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189123200000",
"number": "1285722041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2758",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507042758",
"telephone_number": "319-235-5390",
"fax_number": "319-287-9249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1753 W RIDGEWAY AVE",
"address_2": "SUITE 111",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507014588",
"telephone_number": "319-833-5970",
"fax_number": "319-833-5971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARNACK",
"first_name": "SARA",
"middle_name": "BETH",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IA",
"license": "00467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0487157",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.