Individual provider Active NPI

Carol Reid Runyan, AUD

  • Audiologist-Hearing Aid Fitter
  • Johnson City, TN
National Provider Identifier
1316929458
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
2101001591 Issued in VA
Practice address
701 N State of Franklin Rd Ste 5
Johnson City, TN 37604-3645
Phone
(423) 928-9285
Fax
(423) 328-0795
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001303 VA
Audiologist 231H00000X A0000001097 TN
Hearing Instrument Specialist 237700000X
Audiologist-Hearing Aid Fitter 237600000X 2101001591 VA Primary

Addresses

Primary practice location

701 N State of Franklin Rd Ste 5
Johnson City, TN 37604-3645

Mailing address

6700 Washington Ave S
Eden Prairie, MN 55344-3405
Phone (800) 328-8602

Other practice location 1

9430 Park West Blvd Ste 330
Knoxville, TN 37923-4203
Phone (865) 693-6065

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231129001723 AZ Practitioner - Qualified Audiologist 3577518257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

2680 S Ave B
Yuma, AZ 85364-6901
Phone (928) 336-1476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A0000001097TNMDAudiologist
2201001303VAMDAudiologist
2101001591VAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Oct 15, 2023 Accepting new patients
Yuma Regional Medical Center CurrentSince Oct 15, 2023 Accepting new patients
Bristol Regional Speech & Hearing Center Audiologist PastSince Sep 20, 2022 Accepting new patients
Bristol Regional Speech & Hearing Center Audiologist PastSince Sep 20, 2022 Accepting new patients
Associated Hearings & Diagnostics Past Accepting new patients
Associated Hearings & Diagnostics Audiologist PastSince Jun 1, 2007 Accepting new patients

Locations

2680 S Avenue B
Yuma, AZ 85364
Phone (928) 336-1476

2851 S Avenue B
Ste 2504
Yuma, AZ 85364
Phone (928) 271-6105

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Organizations & group practices 6

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1316929458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 WASHINGTON AVE S",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443405",
            "telephone_number": "800-328-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N STATE OF FRANKLIN RD STE 5",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043645",
            "telephone_number": "423-928-9285",
            "fax_number": "423-328-0795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9430 Park West Blvd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234203",
            "country_code": "US",
            "telephone_number": "865-693-6065",
            "fax_number": "865-531-6325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "CAROL",
        "middle_name": "REID",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001303",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "A0000001097",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2101001591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.