Individual provider Active NPI

Kaitlyn Golemon, AU.D

  • Audiologist
  • San Tan Valley, AZ
National Provider Identifier
1407555402
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA14343 Issued in AZ
Practice address
36305 N Gantzel Rd Ste 104
San Tan Valley, AZ 85140-7326
Phone
(480) 331-6521
Fax
(480) 420-3659
NPI assigned
Feb 28, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA14343 AZ Primary

Addresses

Primary practice location

36305 N Gantzel Rd Ste 104
San Tan Valley, AZ 85140-7326

Mailing address

36305 N Gantzel Rd Ste 104
San Tan Valley, AZ 85140-7326
Phone (480) 331-6521

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230307003266 AZ Practitioner - Qualified Audiologist 5698148971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Priority Hearing and Balance LLCGroup PAC ID 3870802952, 4 clinicians

Practice addresses (Care Compare)

36305 N Gantzel Rd
Suite 104
San Tan Valley, AZ 85140-7326
Phone (480) 331-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Conifer Hearing and Tinnitus Audiologist CurrentSince Jun 25, 2023 Accepting new patients
Priority Hearing and Balance LLC Audiologist CurrentSince Mar 1, 2023 Accepting new patients

Locations

36305 N Gantzel Rd
Ste 104
San Tan Vly, AZ 85140
Phone (480) 331-6521

10325 E Riggs Rd
Ste 105
Sun Lakes, AZ 85248
Phone (480) 331-6521

Organizations & group practices 2

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": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1407555402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36305 N GANTZEL RD STE 104",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407326",
            "telephone_number": "480-331-6521",
            "fax_number": "480-420-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36305 N GANTZEL RD STE 104",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407326",
            "telephone_number": "480-331-6521",
            "fax_number": "480-420-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLEMON",
        "first_name": "KAITLYN",
        "name_prefix": "Mrs.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA14343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.