Individual provider Active NPI

Clint D Keifer, AUD

  • Audiologist
  • Toledo, OH
National Provider Identifier
1366605974
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A01628 Issued in OH
Practice address
3780 King Rd
Suite 2C
Toledo, OH 43617-1400
Phone
(419) 327-2273
Fax
(419) 517-4418
NPI assigned
Jul 3, 2008
Last updated
May 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01628 OH Primary

Addresses

Primary practice location

3780 King Rd
Suite 2C
Toledo, OH 43617-1400

Mailing address

3780 King Rd
Suite 2C
Toledo, OH 43617-1400
Phone (419) 327-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090901000410 OH Practitioner - Qualified Audiologist 9931254695 Practice locations: Toledo, OH

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3780 King Rd
Toledo, OH 43617-1400
Phone (419) 327-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A01628OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Audiology, LLC Audiologist PastSince Dec 13, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1366605974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 KING RD",
            "address_2": "SUITE 2C",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171400",
            "telephone_number": "419-327-2273",
            "fax_number": "419-517-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 KING RD",
            "address_2": "SUITE 2C",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171400",
            "telephone_number": "419-327-2273",
            "fax_number": "419-517-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIFER",
        "first_name": "CLINT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.