Kimberly Catherine Nieblas, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

31089 Issued in OR

Practice address

2222 NW Lovejoy St Ste 607
Portland, OR 97210-5104

Phone

(503) 222-3638

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

PDX ENT and Audiology Medical Group PCGroup PAC ID 8820397086, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• PDX ENT and Audiology Medical Group PC

  • Otolaryngology Physician
  • Portland, OR
  • NPI 1578923751
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1396522504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-222-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-222-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17895 NW Evergreen Pkwy Ste 130",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970067402",
            "country_code": "US",
            "telephone_number": "503-222-3638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEBLAS",
        "first_name": "KIMBERLY",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "31089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roslyn Nicoll
• Alexander Demetre Nicoloff, M.D.
• Ron Nida
• Mary Anne Joseph Nidiry, MD
• Dolores A Niebergall, PT
• Edouard Niedenthal Duret
• Jayne Niederkorn
• Sally Jo Niedermeyer, RN
• Hunter Douglas Niehus, MD
• Karlyn Nieland

• Audiologist in Portland, OR
• Providers in Portland, OR by specialty
• Audiologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.