NPIMap

Organization Active NPI

The Pennsylvania State University

Doing business as Speech and Hearing Clinic

  • Hearing and Speech Clinic/Center
  • University Park, PA
National Provider Identifier
1356670608
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
THE PENNSYLVANIA STATE UNIVERSITY
Doing business as
Speech and Hearing Clinic
Practice address
110 Ford BLDG
University Park, PA 16802-3000
Phone
(814) 865-5414
Fax
(814) 863-3759
NPI assigned
Dec 16, 2009
Last updated
Jul 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Dr. Diane Williams, PHD
Title
Department Head
Phone
(814) 865-3177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU Primary

Addresses

Primary practice location

110 Ford BLDG
University Park, PA 16802-3000

Mailing address

110 Ford BLDG
University Park, PA 16802-3000
Phone (814) 865-5414

Other names 1

  • Speech and Hearing Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308000633 PA Part B Supplier - Clinic/Group Practice 8426002908 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: University Park, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Psu Psych Clinic11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1356670608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FORD BLDG",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168023000",
            "telephone_number": "814-865-5414",
            "fax_number": "814-863-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FORD BLDG",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168023000",
            "telephone_number": "814-865-5414",
            "fax_number": "814-863-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PENNSYLVANIA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "DEPARTMENT HEAD",
        "authorized_official_telephone_number": "814-865-3177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speech and Hearing Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Speech and Hearing Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in University Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.