Jka5 Hudson Inc

Primary specialty

AudiologistTaxonomy code 231H00000X

Legal business name

JKA5 HUDSON INC

Practice address

411 Stageline Rd # 290
Hudson, WI 54016-7848

Phone

(715) 531-6710

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Kevin AmdahlNPI 1972624286

Title

Owner

Phone

(320) 252-0094

Specialties & licenses 1

Addresses

Other names 1

• Amdahl Hearing Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Amdahl, MA

  • Audiologist-Hearing Aid Fitter
  • Saint Cloud, MN
  • NPI 1972624286

  WI

  Medicare reassignment Care Compare group Authorized official
• Ryan William Schwantes, AUD

  • Audiologist
  • Hudson, WI
  • NPI 1720874928
  Medicare reassignment Care Compare group NPD
• Raena Sue Deperry, AUD

  • Audiologist
  • Hudson, WI
  • NPI 1114018447
  Medicare reassignment Care Compare group
• Daniel Dibenedetto

  • Audiologist
  • River Falls, WI
  • NPI 1326778416
  Medicare reassignment

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417484239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 2ND ST S",
            "address_2": "SUITE 185",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014594",
            "telephone_number": "320-252-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 STAGELINE RD # 290",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167848",
            "telephone_number": "715-531-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JKA5 HUDSON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AMDAHL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-252-0094"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amdahl Hearing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura James, BS
• Brenton Curtis Jenkins, MD
• Stephanie Jensen, LCSW
• Jerrys Enterprises Inc
• Jill Ann Anderson and Associates, LLC
• Victoria Jean Johanneck, PSY.D., M.DIV.
• Brooke Catherine John
• Michele Johnsen
• Eric Johnson, PHARMD
• Heather Nicole Johnson

• Audiologist in Hudson, WI
• Providers in Hudson, WI by specialty
• Audiologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.