Individual provider Active NPI

Michele Tisdale, AU.D CCC-A

  • Audiologist
  • Louisville, KY
National Provider Identifier
1407744543
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
300505 Issued in KY
Practice address
117 E Kentucky St
Louisville, KY 40203-2793
Phone
(502) 584-3573
Fax
(502) 515-3325
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 300505 KY Primary

Addresses

Primary practice location

117 E Kentucky St
Louisville, KY 40203-2793

Mailing address

111 E Kentucky St
Louisville, KY 40203-2793
Phone (502) 584-3573

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 E Kentucky St
Louisville, KY 40203-2793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heuser Hearing & Language Academy PastSince Jul 1, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1407744543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E KENTUCKY ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032793",
            "telephone_number": "502-584-3573",
            "fax_number": "502-515-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E KENTUCKY ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032793",
            "telephone_number": "502-584-3573",
            "fax_number": "502-515-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "MICHELE",
        "credential": "AU.D CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "300505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.