NPIMap

Organization Active NPI

Animas Valley Audiology Associates LLC

  • Audiologist
  • Durango, CO
National Provider Identifier
1467616573
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
519 Issued in CO
Legal business name
ANIMAS VALLEY AUDIOLOGY ASSOCIATES LLC
Practice address
799 E 3Rd St
Suite
Durango, CO 81301-5793
Phone
(970) 375-2369
Fax
(970) 375-9054
NPI assigned
Jul 17, 2008
Last updated
Jan 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Mrs. Chandace Kayla Jeep, AU, DNPI 1902978943
Title
Owner
Phone
(970) 375-2369

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
Audiologist 231H00000X 519 CO Primary

Addresses

Primary practice location

799 E 3Rd St
Suite
Durango, CO 81301-5793

Mailing address

799 E 3Rd St
Suite
Durango, CO 81301-5793
Phone (970) 375-2369

Other identifiers 2

IdentifierTypeStateIssuer
519OtherCOSTATE LICENSE NUMBER
519OtherCOSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090212000238 CO Part B Supplier - Clinic/Group Practice 5496853426 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Cortez, CO; Durango, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Animas Valley Audiology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

799 E 3rd St
Durango, CO 81301
Phone (970) 375-2369

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1467616573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 E 3RD ST",
            "address_2": "SUITE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015793",
            "telephone_number": "970-375-2369",
            "fax_number": "970-375-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 E 3RD ST",
            "address_2": "SUITE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015793",
            "telephone_number": "970-375-2369",
            "fax_number": "970-375-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANIMAS VALLEY AUDIOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "JEEP",
        "authorized_official_first_name": "CHANDACE",
        "authorized_official_middle_name": "KAYLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-375-2369",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AU, D"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "519",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "519",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.