Active NPI
John J Hetherington, PH.D.
- Audiologist
- Casa Grande, AZ
National Provider Identifier
1508869488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- DA4090
- Practice address
- 177 W Cottonwood LN
Ste 7
Casa Grande, AZ 85222-2552 - Phone
- (520) 836-4618
- Fax
- (520) 836-2650
- NPI assigned
- May 24, 2005
- Reactivated
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | DA4090 | AZ | Primary |
Addresses
Primary practice location
177 W Cottonwood LN
Ste 7
Casa Grande, AZ 85222-2552
Mailing address
177 W Cottonwood LN
Ste 7
Casa Grande, AZ 85222-2552
Phone (520) 836-4618
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZOO76260 | Other | AZ | BLUE CROSS/BLUE SHIELD |
| 133376 | Other | WA | DEPT OF LABOR & INDUSTRIE |
| 1Z2179 | Other | AZ | HEALTHNET |
| 802117 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA4090 | AZ | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508869488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "177 W COTTONWOOD LN",
"address_2": "STE 7",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "852222552",
"telephone_number": "520-836-4618",
"fax_number": "520-836-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 W COTTONWOOD LN",
"address_2": "STE 7",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "852222552",
"telephone_number": "520-836-4618",
"fax_number": "520-836-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETHERINGTON",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2026-07-13",
"deactivation_date": "2006-03-16",
"reactivation_date": "2006-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AZ",
"license": "DA4090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "AZOO76260",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRIE",
"identifier": "133376",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "1Z2179",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "802117",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Casa Grande, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.