Individual provider Active NPI

John R Salisbury, AUD

  • Audiologist
  • Clifton Springs, NY
National Provider Identifier
1487678959
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
000437 Issued in NY
Practice address
4 Coulter Rd
Clifton Springs, NY 14432-1122
Phone
(315) 462-1368
Fax
(315) 462-6201
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 000437 NY Primary

Addresses

Primary practice location

4 Coulter Rd
Clifton Springs, NY 14432-1122

Mailing address

67 Kendall St
Suite 200
Clifton Springs, NY 14432-9701
Phone (315) 462-9482

Other identifiers 1

IdentifierTypeStateIssuer
02009772MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000392 NY Practitioner - Qualified Audiologist 8628056256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

266 Main St
Phelps, NY 14532-9607
Phone (315) 462-1368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000437NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Audiology Audiologist PastSince May 20, 2002 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1487678959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 KENDALL ST",
            "address_2": "SUITE 200",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144329701",
            "telephone_number": "315-462-9482",
            "fax_number": "315-462-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-1368",
            "fax_number": "315-462-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALISBURY",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "000437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02009772",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.