Individual provider Active NPI

Richard Layne Luekenga Jr., AU.D.

  • Audiologist
  • St George, UT
National Provider Identifier
1609818905
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5935522-4101
Practice address
1054 East Riverside Dr.,
Suite 201
St George, UT 84790-4825
Phone
(435) 688-8991
Fax
(435) 688-2122
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 5935522-4101 UT
Audiologist 231H00000X 5935522-4101 Primary

Addresses

Primary practice location

1054 East Riverside Dr.,
Suite 201
St George, UT 84790-4825

Mailing address

1054 East Riverside Dr
Suite 201
St George, UT 84790-4825
Phone (435) 688-8991

Other identifiers 1

IdentifierTypeStateIssuer
D6362MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051018000458 UT Practitioner - Qualified Audiologist 5092731356 Reassigns benefits to 1 organization
I20070910001039 NV Practitioner - Qualified Audiologist 5092731356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Louisville School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dixie Hearing and Balance CenterGroup PAC ID 3577589837, 4 clinicians
Nevada Hearing and Balance Center LLCGroup PAC ID 5092842393, 5 clinicians

Practice addresses (Care Compare)

1054 E Riverside Dr
Suite 201
St George, UT 84790-4829
Phone (435) 688-8991

1742 W Horizon Ridge Pkwy
Suite 100
Henderson, NV 89012-4915
Phone (702) 896-0031

340 Falcon Ridge Pkwy
BLDG 500
Mesquite, NV 89027-8850
Phone (435) 688-8991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5935522-4101UTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Hearing & Balance Center LLC Audiologist CurrentSince Feb 15, 2010 Accepting new patients
Dixie Hearing & Balance Center Audiologist CurrentSince Aug 1, 2005 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Alan Jones D.O. P.C. Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients

Locations

1742 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89012
Phone (702) 896-0031

1301 Bertha Howe Ave
Ste 6
Mesquite, NV 89027
Phone (435) 900-6001

340 Falcon Ridge Pkwy
Bldg 500
Mesquite, NV 89027
Phone (435) 688-8991

1251 Northfield Rd
Ste 202
Cedar City, UT 84721
Phone (435) 688-8991

1054 E Riverside Dr
Ste 201
St George, UT 84790
Phone (435) 628-4507

630 S 400 E
Ste 103
St George, UT 84770
Phone (435) 634-8848

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1609818905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 EAST RIVERSIDE DR",
            "address_2": "SUITE 201",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904825",
            "telephone_number": "435-688-8991",
            "fax_number": "435-688-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 EAST RIVERSIDE DR.,",
            "address_2": "SUITE 201",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904825",
            "telephone_number": "435-688-8991",
            "fax_number": "435-688-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEKENGA",
        "first_name": "RICHARD",
        "middle_name": "LAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "5935522-4101",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": "5935522-4101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D6362",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.