Organization Active NPI

Waterville Audiology PC

Doing business as Waterville Audiology

  • Audiologist
  • Waterville, ME
National Provider Identifier
1457905911
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
WATERVILLE AUDIOLOGY PC
Doing business as
Waterville Audiology
Practice address
105 Kennedy Memorial Dr
Waterville, ME 04901-5131
Phone
(207) 872-0320
Fax
(207) 872-0330
NPI assigned
Aug 1, 2019
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Jennifer RancourtNPI 1801570098
Title
Owner
Phone
(207) 577-3310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU Primary
Audiologist-Hearing Aid Fitter 237600000X NU

Addresses

Primary practice location

105 Kennedy Memorial Dr
Waterville, ME 04901-5131

Mailing address

105 Kennedy Memorial Dr
Waterville, ME 04901-5131
Phone (207) 872-0320

Other names 1

  • Waterville Audiology Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.watervilleaudiology.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191009002219 ME Part B Supplier - Clinic/Group Practice 9234460064 Receives reassigned benefits from 3 practitioners
Practice locations: Waterville, ME

National Provider Directory

National Provider Directory

Locations

105 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 577-3310

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1457905911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015131",
            "telephone_number": "207-872-0320",
            "fax_number": "207-872-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015131",
            "telephone_number": "207-872-0320",
            "fax_number": "207-872-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERVILLE AUDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-01",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "RANCOURT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-577-3310"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.watervilleaudiology.com",
            "affiliation": "N",
            "address_1": "124 Silver Street",
            "city": "Waterville",
            "state": "ME",
            "country_code": "US",
            "postal_code": "04901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Waterville Audiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waterville Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.