Individual provider Active NPI

James Waide Hankla, AU.D., CCC-A

  • Audiologist
  • Waycross, GA
National Provider Identifier
1437155108
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD000531 Issued in GA
Practice address
1705 Boulevard SQ Ste B
Waycross, GA 31501
Phone
(912) 284-9200
Fax
(912) 284-9887
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY392 FL
Audiologist-Hearing Aid Fitter 237600000X AUD000531 GA
Audiologist 231H00000X AUD000531 GA Primary

Addresses

Primary practice location

1705 Boulevard SQ Ste B
Waycross, GA 31501

Mailing address

1705 Boulevard SQ Ste B
Waycross, GA 31501-8032
Phone (912) 284-9200

Other identifiers 3

IdentifierTypeStateIssuer
000701984CMedicaidGA
055083858AMedicaidGA
000701984BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000116 GA Practitioner - Qualified Audiologist 7719022995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD000531GAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Hearcare Audiology Audiologist CurrentSince Jul 5, 2000 Accepting new patients

Locations

1701 Boulevard Sq
Ste F
Waycross, GA 31501
Phone (229) 469-6932

1705 Boulevard Sq
Ste B
Waycross, GA 31501
Phone (912) 284-9200

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1437155108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 BOULEVARD SQ STE B",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018032",
            "telephone_number": "912-284-9200",
            "fax_number": "912-284-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 BOULEVARD SQ STE B",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31501",
            "telephone_number": "912-284-9200",
            "fax_number": "912-284-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKLA",
        "first_name": "JAMES",
        "middle_name": "WAIDE",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY392",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "GA",
            "license": "AUD000531",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD000531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000701984C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055083858A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000701984B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.