Individual provider Active NPI

Anna Main, AU.D.

  • Audiologist
  • Bloomington, IN
National Provider Identifier
1639584766
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002514A Issued in IN
Practice address
200 S Jordan Ave
Bloomington, IN 47405-7002
Phone
(812) 855-7439
NPI assigned
Jun 27, 2014
Last updated
Jul 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
201233990MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531000160 IN Practitioner - Qualified Audiologist 6608166970 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23002514AINMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hear Again Columbus LLC Audiologist CurrentSince Jun 18, 2024 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.

Verify at the official NPI Registry.