Active NPI
Nan Targovnik, M.A.,CCC-A
- Audiologist
- Edison, NJ
National Provider Identifier
1619993110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 41YA00015000
- Practice address
- 1455 US Highway 1
Edison, NJ 08837-2418 - Phone
- (732) 549-7455
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 41YA00015000 | NJ | Primary |
Addresses
Primary practice location
1455 US Highway 1
Edison, NJ 08837-2418
Mailing address
P.O Box 406153
Atlanta, GA 30384-1876
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7121105 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hearusa Inc | Audiologist | Past | Accepting new patients |
| Hearusa Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Audiologist-Hearing Aid Fitter
- West Palm Beach, FL
- NPI 1073560231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256169600000",
"number": "1619993110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O BOX 406153",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303841876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 US HIGHWAY 1",
"city": "EDISON",
"state": "NJ",
"postal_code": "088372418",
"telephone_number": "732-549-7455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARGOVNIK",
"first_name": "NAN",
"credential": "M.A.,CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2009-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NJ",
"license": "41YA00015000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7121105",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.