Amanda Ehrenberg-Koch, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

775 Issued in NE

Practice address

2415 E 23Rd Ave S
Suite 100
Fremont, NE 68025-2407

Phone

(402) 727-7866

NPI assigned

May 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Ehrenberg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1295113124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 E 23RD AVE S",
            "address_2": "SUITE 100",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252407",
            "telephone_number": "402-727-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 E 23RD AVE S",
            "address_2": "SUITE 100",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252407",
            "telephone_number": "402-727-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRENBERG-KOCH",
        "first_name": "AMANDA",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NE",
            "license": "775",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IA",
            "license": "075886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "EHRENBERG",
            "credential": "HIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Fremont, NE
• Hearing Instrument Specialist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.