Individual provider Active NPI

Erika Shakespeare, CCC-A

  • Audiologist
  • La Grande, OR
National Provider Identifier
1487963948
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD1096 Issued in ID
Practice address
710 Sunset Dr Ste F
La Grande, OR 97850-1200
Phone
(541) 663-3100
Fax
(541) 975-5135
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 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 AUD1096 ID Primary

Addresses

Primary practice location

710 Sunset Dr Ste F
La Grande, OR 97850-1200

Mailing address

1404 4TH St
La Grande, OR 97850-2502
Phone (541) 612-7555

Other practice location 1

510 N 2nd St Ste 201
Boise, ID 83702-6078
Phone (208) 385-3440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210001085 OR Practitioner - Qualified Audiologist 7618157496 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audiology and Hearing Aid AssociatesGroup PAC ID 7810277308, 2 clinicians
Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

1404 4TH St
La Grande, OR 97850-2502
Phone (541) 612-7555

900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421

PO Box
Suite 3290
La Grande, OR 97850-7290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD1096IDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. CurrentSince Oct 1, 2014 Accepting new patients
Grande Ronde Hospital, Inc CurrentSince Oct 1, 2014 Accepting new patients
Audiology and Hearing Aid Associates Audiologist CurrentSince Dec 26, 2016 Accepting new patients
Grande Ronde Hospital, Inc. Current Accepting new patients

Locations

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

710 Sunset Dr
Ste F
La Grande, OR 97850
Phone (541) 663-3100

1404 4th St
La Grande, OR 97850
Phone (208) 761-8065

710 Sunset Dr
Ste Dq
La Grande, OR 97850

Organizations & group practices 10

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": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1487963948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 4TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978502502",
            "telephone_number": "541-612-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 SUNSET DR STE F",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501200",
            "telephone_number": "541-663-3100",
            "fax_number": "541-975-5135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 N 2nd St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026078",
            "country_code": "US",
            "telephone_number": "208-385-3440",
            "fax_number": "208-385-3440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKESPEARE",
        "first_name": "ERIKA",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "AUD1096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.