Individual provider Active NPI

Dana Alise Nolen, AU.D.

  • Audiologist
  • Middletown, OH
National Provider Identifier
1508926791
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-01174 Issued in OH
Practice address
1040A Summitt Dr
Middletown, OH 45042-3400
Phone
(513) 422-6516
Fax
(516) 422-5199
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-01174 OH Primary

Addresses

Primary practice location

1040A Summitt Dr
Middletown, OH 45042-3400

Mailing address

1040A Summitt Dr
Middletown, OH 45042-3400
Phone (513) 422-6516

Other practice location 1

1044 Summitt Dr
Middletown, OH 45042-3400
Phone (513) 422-6516

Other identifiers 1

IdentifierTypeStateIssuer
4107242OtherOHMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000399 OH Practitioner - Qualified Audiologist 6901092964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Grupenhof Enterprises LLCGroup PAC ID 4981908050, 4 clinicians

Practice addresses (Care Compare)

1040 A Summit Dr
Middletown, OH 45042-3400
Phone (513) 422-6516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A-01174OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grupenhof Enterprises, LLC Audiologist CurrentSince Oct 24, 2016 Accepting new patients

Locations

1044 Summit Dr
Middletown, OH 45042
Phone (513) 422-6516

1040A Summit Dr
Middletown, OH 45042
Phone (513) 422-6516

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1508926791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040A SUMMITT DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423400",
            "telephone_number": "513-422-6516",
            "fax_number": "516-422-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040A SUMMITT DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423400",
            "telephone_number": "513-422-6516",
            "fax_number": "516-422-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 Summitt Dr",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450423400",
            "country_code": "US",
            "telephone_number": "513-422-6516",
            "fax_number": "516-422-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "DANA",
        "middle_name": "ALISE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-01174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4107242",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.