Individual provider Active NPI

Ellen M Emmons, AU.D

  • Audiologist
  • Florence, SC
National Provider Identifier
1487957304
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3692 Issued in OK
Practice address
153 E N B Baroody St
Florence, SC 29506-2523
Phone
(843) 662-7802
Fax
(843) 662-5609
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3692 OK Primary

Addresses

Primary practice location

153 E N B Baroody St
Florence, SC 29506-2523

Mailing address

153 E N B Baroody St
Florence, SC 29506-2523
Phone (843) 662-7802

Other identifiers 8

IdentifierTypeStateIssuer
6987236OtherNCCIGNA
P01377062OtherNCMEDICARE, RAILROAD
P01388645OtherSCRAILROAD MEDICARE
30121507OtherSCSELECT HEALTH OF SC
9790602OtherNCAETNA
Q427035874OtherSCMEDICARE
7413812MedicaidNC
SAN101MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130411000044 SC Practitioner - Qualified Audiologist 7719168335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

153 E N B Baroody St
Florence, SC 29506-2523
Phone (843) 662-7802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Ear Nose & Throat, Gaffney Office CurrentSince Nov 15, 2017 Accepting new patients
Pee Dee Hearing Center Audiologist CurrentSince Sep 13, 2023 Accepting new patients
Spartanburg Ear Nose & Throat, Head & Neck Surgery PA CurrentSince Apr 9, 2023 Accepting new patients

Locations

153 E N B Baroody St
Florence, SC 29506
Phone (843) 662-7802

2755 S Highway 14
Ste 2400
Greer, SC 29650
Phone (864) 582-2900

1330 Boiling Springs Rd
Ste 1400
Spartanburg, SC 29303
Phone (864) 278-1442

Organizations & group practices 3

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": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1487957304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 E N B BAROODY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062523",
            "telephone_number": "843-662-7802",
            "fax_number": "843-662-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E N B BAROODY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062523",
            "telephone_number": "843-662-7802",
            "fax_number": "843-662-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "3692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6987236",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, RAILROAD",
            "identifier": "P01377062",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01388645",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH OF SC",
            "identifier": "30121507",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9790602",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q427035874",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7413812",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SAN101",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.