Active NPI
Ellen Jean Verlo
- Audiologist-Hearing Aid Fitter
- Davenport, IA
National Provider Identifier
1467544676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- AUD-242 HA-434
- Practice address
- 2215 E 52ND St
2
Davenport, IA 52807-2786 - Phone
- (563) 355-7712
- Fax
- (563) 359-1325
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | AUD-242 HA-434 | IA | Primary |
Addresses
Primary practice location
2215 E 52ND St
2
Davenport, IA 52807-2786
Mailing address
2215 E 52ND St
2
Davenport, IA 52807-2786
Phone (563) 355-7712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040444 | Medicaid | IA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AUD-242 HA-434 | IA | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1467544676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 E 52ND ST",
"address_2": "2",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528072786",
"telephone_number": "563-355-7712",
"fax_number": "563-359-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 E 52ND ST",
"address_2": "2",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528072786",
"telephone_number": "563-355-7712",
"fax_number": "563-359-1325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERLO",
"first_name": "ELLEN",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "IA",
"license": "AUD-242 HA-434",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0040444",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.