Active NPI
Susan R. Naidu
- Audiologist
- Salt Lake City, UT
National Provider Identifier
1508945072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 5713788-4101
- Practice address
- 417 Wakara Way
Salt Lake City, UT 84108-1436 - Phone
- (801) 581-2121
- NPI assigned
- Nov 3, 2006
- Sex
- Female
- 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 | 5713788-4101 | UT | Primary |
Addresses
Primary practice location
417 Wakara Way
Salt Lake City, UT 84108-1436
Mailing address
PO Box 58896
Salt Lake City, UT 84158-0896
Phone (801) 213-3800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | snaidu29623@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5713788-4101 | UT | MD | Audiologist |
Interoperability endpoints
- snaidu29623@direct.med.utah.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1508945072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 58896",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841580896",
"telephone_number": "801-213-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 WAKARA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081436",
"telephone_number": "801-581-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAIDU",
"first_name": "SUSAN",
"middle_name": "R.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "UT",
"license": "5713788-4101",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "snaidu29623@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.