Jessica Renee Stich-Hennen, AU.D., F-AAA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AUD-1736 Issued in ID

Practice address

510 N 2ND St
Suite #201
Boise, ID 83702-6077

Phone

(208) 489-4743

Fax

(208) 489-4075

NPI assigned

Nov 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1578840153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N 2ND ST",
            "address_2": "SUITE #201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026077",
            "telephone_number": "208-489-4743",
            "fax_number": "208-489-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N 2ND ST",
            "address_2": "SUITE #201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026077",
            "telephone_number": "208-489-4743",
            "fax_number": "208-489-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICH-HENNEN",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "AU.D., F-AAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "AUD-1736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jyntri Stewart
• Lee E Stewart
• Mary K Stewart, RN
• Tyler S Stewart, PA
• Illa Stice
• Holland Noel Stidham, LPC
• Derek Louis Stiegemeier, PHYSICAL THERAPIST
• Rose M Stiles Johnson
• Emma Stiles St Clair
• Kathryn Still, PMHNP

• Audiologist in Boise, ID
• Providers in Boise, ID by specialty
• Audiologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.