Organization Active NPI

Audiology Specialty Clinic

  • Audiologist
  • Sioux Falls, SD
National Provider Identifier
1609137942
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
375 Issued in SD
Legal business name
AUDIOLOGY SPECIALTY CLINIC
Practice address
5124 S Western Ave
Suite 4
Sioux Falls, SD 57108-5047
Phone
(605) 275-5545
Fax
(605) 275-5546
NPI assigned
Jun 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Dr. Lindsey Koch, AUDNPI 1487964144
Title
Owner
Phone
(605) 275-5545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X 375 SD Primary
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X 11 SD
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X 16 SD

Addresses

Primary practice location

5124 S Western Ave
Suite 4
Sioux Falls, SD 57108-5047

Mailing address

5124 S Western Ave
Suite 4
Sioux Falls, SD 57108-5047
Phone (605) 275-5545

Other identifiers 6

IdentifierTypeStateIssuer
375OtherSDAUDIOLOGY LICENSE
1487964144OtherSDNPI
1184899882OtherSDNPI
1538334131OtherSDNPI
16OtherSDAUDIOLOGY LICENSE
11OtherSDAUDIOLOGY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120905000814 SD Part B Supplier - Clinic/Group Practice 2062669500 Receives reassigned benefits from 2 practitioners
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

5124 S Western Ave
Ste 4
Sioux Falls, SD 57108
Phone (605) 274-3898

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1609137942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 S WESTERN AVE",
            "address_2": "SUITE 4",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085047",
            "telephone_number": "605-275-5545",
            "fax_number": "605-275-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5124 S WESTERN AVE",
            "address_2": "SUITE 4",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085047",
            "telephone_number": "605-275-5545",
            "fax_number": "605-275-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDIOLOGY SPECIALTY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-275-5545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "SD",
            "license": "375",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "SD",
            "license": "11",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "SD",
            "license": "16",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY LICENSE",
            "identifier": "375",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487964144",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184899882",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538334131",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY LICENSE",
            "identifier": "16",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY LICENSE",
            "identifier": "11",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.