Individual provider Active NPI

Jared T Anderson, AU.D.

  • Audiologist
  • Paducah, KY
National Provider Identifier
1609367655
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
4570 Pecan Dr Ste a
Paducah, KY 42001-6717
Phone
(270) 554-6000
Fax
(270) 554-6995
NPI assigned
May 25, 2018
Last updated
May 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X KY Primary

Addresses

Primary practice location

4570 Pecan Dr Ste a
Paducah, KY 42001-6717

Mailing address

4570 Pecan Dr Ste a
Paducah, KY 42001-6717
Phone (270) 554-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180919001546 KY Practitioner - Qualified Audiologist 5496006181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milliano Audiology LLCGroup PAC ID 0941199434, 3 clinicians

Practice addresses (Care Compare)

4570 Pecan Dr
Suite a
Paducah, KY 42001-6717
Phone (270) 554-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Milliano Audiology LLC CurrentSince Jul 9, 2013 Accepting new patients

Locations

1713 State Route 121 N
Murray, KY 42071
Phone (270) 759-7000

4570 Pecan Dr
Ste A
Paducah, KY 42001
Phone (270) 554-6000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1609367655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 PECAN DR STE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016717",
            "telephone_number": "270-554-6000",
            "fax_number": "270-554-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 PECAN DR STE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420016717",
            "telephone_number": "270-554-6000",
            "fax_number": "270-554-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JARED",
        "middle_name": "T",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.