Annastatia Rebal, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

00552 Issued in IA

Practice address

415 10TH Ave
P.O. 5637
Coralville, IA 52241-2389

Phone

(319) 338-6043

Fax

(319) 338-7739

NPI assigned

Mar 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568592160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 ESTHER ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 10TH AVE",
            "address_2": "P.O. 5637",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412389",
            "telephone_number": "319-338-6043",
            "fax_number": "319-338-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBAL",
        "first_name": "ANNASTATIA",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "00552",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "00833",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0493155",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Coralville, IA
• Providers in Coralville, IA by specialty
• Audiologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.