Matthew R Brady, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1774 Issued in TN

Practice address

301 Louis St
Suite 101
Kingsport, TN 37660-5181

Phone

(423) 246-4600

Fax

(423) 246-3311

NPI assigned

Aug 28, 2016

Last updated

Sep 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Qualified Audiologist

Education

Ohio Medical University, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Mountain Region Speech and Hearing CenterGroup PAC ID 8628003589, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mountain Region Speech and Hearing Center

  • Speech-Language Pathologist
  • Kingsport, TN
  • NPI 1861427783
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1386190585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 813",
            "address_2": "200 POCAHONTAS TRAIL",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249860813",
            "telephone_number": "304-536-5030",
            "fax_number": "304-536-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LOUIS ST",
            "address_2": "SUITE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605181",
            "telephone_number": "423-246-4600",
            "fax_number": "423-246-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "1774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q023491",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Evan Boykin, BSW
• John W Boyle, M.D.
• Stephanie Smith Boyles, LCSW
• Heather Braddock, LPC-MHSP
• Eve M Bradford, APRN
• William James Brant, CRNA
• Charles David Bray, FNP-BC
• Susan R Breeden, FNP-C
• Larry T Breeding, M.D.
• Samuel Breeding, MD

• Audiologist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Audiologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.