Individual provider Active NPI

Ane M Shull, CCC-A

  • Audiologist
  • Springboro, OH
National Provider Identifier
1396731311
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.02561 Issued in OH
Practice address
668 N Main St
Springboro, OH 45066-9553
Phone
(513) 424-7006
Fax
(513) 785-4023
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 50872 TX
Audiologist-Hearing Aid Fitter 237600000X A.02561 OH
Audiologist-Hearing Aid Fitter 237600000X 90561 TX
Audiologist 231H00000X A.02561 OH Primary

Addresses

Primary practice location

668 N Main St
Springboro, OH 45066-9553

Mailing address

750 N Commons Dr Ste 200
Aurora, IL 60504-8025
Phone (630) 303-5380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90561TXMDMental Health Counselor
A.02561OHMDAudiologist
50872TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing, Inc. Audiologist CurrentSince Dec 22, 2024 Accepting new patients

Locations

750 N Commons Dr
Ste 200
Aurora, IL 60504

668 N Main St
Springboro, OH 45066
Phone (513) 424-7006

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1396731311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COMMONS DR STE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605048025",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 N MAIN ST",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669553",
            "telephone_number": "513-424-7006",
            "fax_number": "513-785-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "ANE",
        "middle_name": "M",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "50872",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OH",
            "license": "A.02561",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "90561",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.02561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.