Active NPI
Elisabeth Y Carter, AU.D.
- Audiologist
- Portland, OR
National Provider Identifier
1417070848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 20800
- Practice address
- 2222 NW Lovejoy St Ste 622
Portland, OR 97210-5104 - Phone
- (503) 229-8455
- Fax
- (503) 229-7028
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 20800 | OR | |
| Audiologist | 231H00000X | 20800 | OR | Primary |
Addresses
Primary practice location
2222 NW Lovejoy St Ste 622
Portland, OR 97210-5104
Mailing address
847 NE 19TH Ave Ste 300
Portland, OR 97232-2686
Phone (503) 963-2801
Other practice location 1
3857 Wolverine St NE
Building C, Suite 16
Salem, OR 97305-4270
Phone (503) 588-1039
Other practice location 2
501 N Graham St Ste 350
Portland, OR 97227-2005
Phone (503) 445-9860
Other practice location 3
3857 Wolverine St NE
Building C, Suite 16
Salem, OR 97305-4270
Phone (503) 588-1039
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2095218 | Medicaid | WA | |
| 009303 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20800 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MLM USA LLC | Audiologist | Past | 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": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1417070848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE STE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322686",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 NW LOVEJOY ST STE 622",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972105104",
"telephone_number": "503-229-8455",
"fax_number": "503-229-7028"
}
],
"practiceLocations": [
{
"address_1": "3857 Wolverine St NE",
"address_2": "Building C, Suite 16",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "973054270",
"country_code": "US",
"telephone_number": "503-588-1039",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "501 N Graham St Ste 350",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972272005",
"country_code": "US",
"telephone_number": "503-445-9860",
"fax_number": "503-517-0639",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3857 Wolverine St NE",
"address_2": "Building C, Suite 16",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "973054270",
"country_code": "US",
"telephone_number": "503-588-1039",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARTER",
"first_name": "ELISABETH",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "OR",
"license": "20800",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "20800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2095218",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009303",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.