Individual provider Active NPI

Kimberly Fos Sanborn, AU.D.

  • Audiologist
  • Mandeville, LA
National Provider Identifier
1629231253
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5946 Issued in LA
Practice address
1327 W Causeway Approach
Mandeville, LA 70471-3043
Phone
(985) 419-8080
Fax
(985) 542-0282
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 5946 LA
Audiologist 231H00000X 5946 LA Primary

Addresses

Primary practice location

1327 W Causeway Approach
Mandeville, LA 70471-3043

Mailing address

16038 Doctors Blvd
Hammond, LA 70403-1478
Phone (985) 419-8080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130610000622 LA Practitioner - Qualified Audiologist 4789734369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Hearing and Balance, LLCGroup PAC ID 4789829565, 4 clinicians

Practice addresses (Care Compare)

16038 Doctors Blvd
Hammond, LA 70403-1478
Phone (985) 419-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5946LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Hearing and Balance, LLC Audiologist CurrentSince Jun 15, 2015 Accepting new patients
Creel Hearing Center, LLC Past Accepting new patients
Creel Hearing Center, L.L.C. Audiologist PastSince Aug 21, 2021 Accepting new patients

Locations

16038 Doctors Blvd
Hammond, LA 70403
Phone (985) 327-5905

1327 W Causeway Approach
Mandeville, LA 70471
Phone (985) 419-8080

3545 Highway 190
Mandeville, LA 70471
Phone (985) 626-8744

Organizations & group practices 3

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1629231253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16038 DOCTORS BLVD",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031478",
            "telephone_number": "985-419-8080",
            "fax_number": "985-542-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 W CAUSEWAY APPROACH",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713043",
            "telephone_number": "985-419-8080",
            "fax_number": "985-542-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "KIMBERLY",
        "middle_name": "FOS",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "LA",
            "license": "5946",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "LA",
            "license": "5946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.