Active NPI
Anna Main, AU.D.
- Audiologist
- Bloomington, IN
National Provider Identifier
1639584766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 23002514A
- Practice address
- 200 S Jordan Ave
Bloomington, IN 47405-7002 - Phone
- (812) 855-7439
- NPI assigned
- Jun 27, 2014
- Last updated
- Jul 14, 2016
- 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 | 23002514A | IN | Primary |
Addresses
Primary practice location
200 S Jordan Ave
Bloomington, IN 47405-7002
Mailing address
200 S Jordan Ave
Bloomington, IN 47405-7002
Phone (812) 855-7439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201233990 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23002514A | IN | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hear Again Columbus LLC | Audiologist | Current | Accepting new patients |
Locations
3130 N National Rd
Columbus, IN 47201
Phone (812) 799-0736
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": "1403827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1639584766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S JORDAN AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474057002",
"telephone_number": "812-855-7439",
"fax_number": "812-855-5561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S JORDAN AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474057002",
"telephone_number": "812-855-7439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIN",
"first_name": "ANNA",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-27",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IN",
"license": "23002514A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201233990",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.