NPIMap

Organization Active NPI

Ear Nose and Throat Associates, P.C.

  • Audiologist-Hearing Aid Fitter
  • Johnson City, TN
National Provider Identifier
1598840027
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
A0000000247 Issued in TN
Legal business name
EAR NOSE AND THROAT ASSOCIATES, P.C.
Practice address
215 E Watauga Ave
Johnson City, TN 37601-4671
Phone
(423) 929-9101
Fax
(423) 434-2032
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Authorized official

Name
Mr. Russell J Fankhouser, CCCA
Title
Audiologist
Phone
(423) 929-9101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193400000X SINGLE SPECIALTY GROUP 237600000X A0000000247 TN Primary

Addresses

Primary practice location

215 E Watauga Ave
Johnson City, TN 37601-4671

Mailing address

215 E Watauga Ave
Johnson City, TN 37601-4671
Phone (423) 929-9101

Other identifiers 2

IdentifierTypeStateIssuer
CA7519OtherTNRAILROAD MEDICARE
3373581OtherTNCIGNA MEDICARE

Other names 1

  • Watauga Hearing Conservation Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1598840027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014671",
            "telephone_number": "423-929-9101",
            "fax_number": "423-434-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014671",
            "telephone_number": "423-929-9101",
            "fax_number": "423-434-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE AND THROAT ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "FANKHOUSER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "423-929-9101",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CCCA"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TN",
            "license": "A0000000247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA7519",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "3373581",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watauga Hearing Conservation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.