NPIMap

Organization Active NPI

Modern Audiology Minnesota, Inc.

Doing business as Modern Audiology Minnesota

  • Hearing Aid Equipment
  • Richfield, MN
National Provider Identifier
1457911695
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Aid EquipmentTaxonomy code 332S00000X
Legal business name
MODERN AUDIOLOGY MINNESOTA, INC.
Doing business as
Modern Audiology Minnesota
Practice address
6600 Lyndale Ave S Ste 140
Richfield, MN 55423-3398
Phone
(612) 888-3719
Fax
(612) 354-2665
NPI assigned
Jun 19, 2019
Last updated
Sep 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Mr. Dale Woodard, BC-HISNPI 1578816492
Title
Owner
Phone
(612) 888-3791

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X NU Primary

Addresses

Primary practice location

6600 Lyndale Ave S Ste 140
Richfield, MN 55423-3398

Mailing address

6600 Lyndale Ave S Ste 140
Richfield, MN 55423-3398
Phone (612) 888-3719

Other names 1

  • Modern Audiology Minnesota Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1457911695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 LYNDALE AVE S STE 140",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554233398",
            "telephone_number": "612-888-3719",
            "fax_number": "612-354-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 LYNDALE AVE S STE 140",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554233398",
            "telephone_number": "612-888-3719",
            "fax_number": "612-354-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN AUDIOLOGY MINNESOTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-888-3791",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BC-HIS"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Audiology Minnesota",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Audiology Minnesota",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.