Individual provider Active NPI

Cassandra Kinney, AU.D.

  • Audiologist
  • Fort Wayne, IN
National Provider Identifier
1306461371
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
9604 Coldwater Rd Ste 103
Fort Wayne, IN 46825-2096
Phone
(765) 686-9588
NPI assigned
Jun 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X
Audiologist 231H00000X Primary

Addresses

Primary practice location

9604 Coldwater Rd Ste 103
Fort Wayne, IN 46825-2096

Mailing address

12065 Old Meridian St Ste 205
Carmel, IN 46032-8777
Phone (317) 705-2700

Other names 1

  • Cassandra Dillard Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200902000289 IN Practitioner - Qualified Audiologist 7315363538 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Audiology Associates PCGroup PAC ID 3678465283, 26 clinicians

Practice addresses (Care Compare)

7823 Old State Rd
Suite 60
Sellersburg, IN 47172-1858
Phone (888) 964-6681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Audiology Associates, PC Audiologist CurrentSince Apr 24, 2024 Accepting new patients
Mobile Audiology Associates, P.C. Audiologist CurrentSince Apr 24, 2024 Accepting new patients
Northside ENT, Inc Audiologist CurrentSince Aug 1, 2021 Accepting new patients
Otolaryngology Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

10201 N Illinois St
Ste 110
Carmel, IN 46290
Phone (317) 819-2825

12065 Old Meridian St
Ste 205
Carmel, IN 46032
Phone (317) 844-5656

11725 Illinois St
Ste 445
Carmel, IN 46032
Phone (317) 573-4370

13100 E 136th St
Ste 1200
Fishers, IN 46037
Phone (317) 573-4370

8040 Clearvista Pkwy
Ste 350
Indianapolis, IN 46256

7823 Old State Road 60
Sellersburg, IN 47172
Phone (812) 246-4272

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEEADA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1306461371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12065 OLD MERIDIAN ST STE 205",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328777",
            "telephone_number": "317-705-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9604 COLDWATER RD STE 103",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252096",
            "telephone_number": "765-686-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "CASSANDRA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "DILLARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.