Active NPI
Kresent O'Neille Gurtler, AU.D.
- Audiologist
- Sierra Vista, AZ
National Provider Identifier
1508075607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- DA1304
- Practice address
- 2460 E Wilcox Dr
Sierra Vista, AZ 85635-2841 - Phone
- (520) 459-0688
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | DA1304 | AZ | Primary |
| Assistive Technology Practitioner Audiologist | 231HA2400X | DA1304 | AZ | |
| Assistive Technology Supplier Audiologist | 231HA2500X | DA1304 | AZ | |
| Audiologist-Hearing Aid Fitter | 237600000X | DA1304 | AZ |
Addresses
Primary practice location
2460 E Wilcox Dr
Sierra Vista, AZ 85635-2841
Mailing address
2460 E Wilcox Dr
Sierra Vista, AZ 85635-2841
Phone (520) 459-0688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2460 E Wilcox Dr
Sierra Vista, AZ 85635-2841
Phone (520) 459-0688
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA1304 | AZ | MD | Audiologist-Hearing Aid Fitter |
Organizations & group practices 1
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.
-
- Hearing and Speech Clinic/Center
- Sierra Vista, AZ
- NPI 1760635023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224028800000",
"number": "1508075607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 E WILCOX DR",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352841",
"telephone_number": "520-459-0688",
"fax_number": "520-459-0689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 E WILCOX DR",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856352841",
"telephone_number": "520-459-0688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURTLER",
"first_name": "KRESENT",
"middle_name": "O'NEILLE",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2008-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AZ",
"license": "DA1304",
"primary": true
},
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "AZ",
"license": "DA1304",
"primary": false
},
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "AZ",
"license": "DA1304",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "AZ",
"license": "DA1304",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.