Individual provider Active NPI

Lynne Marie Canales, M.A.

  • Audiologist
  • Centennial, CO
National Provider Identifier
1629124961
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0245444 Issued in CO
Practice address
5217 S Malaya Way
Centennial, CO 80015-6411
Phone
(303) 669-8151
NPI assigned
Jan 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0245444 CO Primary

Addresses

Primary practice location

5217 S Malaya Way
Centennial, CO 80015-6411

Mailing address

5217 S Malaya Way
Centennial, CO 80015-6411
Phone (303) 669-8151

Other identifiers 1

IdentifierTypeStateIssuer
97720364MedicaidCO

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0245444COMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629124961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 S MALAYA WAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800156411",
            "telephone_number": "303-669-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5217 S MALAYA WAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800156411",
            "telephone_number": "303-669-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANALES",
        "first_name": "LYNNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "0245444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97720364",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.