Active NPI
Donald Ray Deardorff
- Hearing Instrument Specialist
- Meridian, ID
National Provider Identifier
1447577135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HAS-P-10127683
- Practice address
- 1116 E Grand Canyon St
Meridian, ID 83646-3662 - Phone
- (707) 628-6163
- NPI assigned
- Apr 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HAS-P-10127683 | OR | Primary |
Addresses
Primary practice location
1116 E Grand Canyon St
Meridian, ID 83646-3662
Mailing address
1116 E Grand Canyon St
Meridian, ID 83646-3662
Phone (707) 628-6163
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HAS-P-10127683 | OR | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271808000000",
"number": "1447577135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 E GRAND CANYON ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836463662",
"telephone_number": "707-628-6163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 E GRAND CANYON ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836463662",
"telephone_number": "707-628-6163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARDORFF",
"first_name": "DONALD",
"middle_name": "RAY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-21",
"last_updated": "2010-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "OR",
"license": "HAS-P-10127683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.