NPIMap

Organization Active NPI

Midwest Audiology, PC

Doing business as Professional Hearing Services

  • Audiologist-Hearing Aid Fitter
  • Minot, ND
National Provider Identifier
1649216169
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
Legal business name
MIDWEST AUDIOLOGY, PC
Doing business as
Professional Hearing Services
Practice address
1400 37TH Ave. SW
Minot, ND 58701-3956
Phone
(701) 852-6565
Fax
(701) 838-9381
NPI assigned
Jun 22, 2006
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Mrs. Andrea B. Larson, AU.D.NPI 1366470593
Title
Audiologist/President
Phone
(701) 852-6565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X ND Primary

Addresses

Primary practice location

1400 37TH Ave. SW
Minot, ND 58701-3956

Mailing address

1400 37TH Ave. SW
Minot, ND 58701-3956
Phone (701) 852-6565

Other identifiers 1

IdentifierTypeStateIssuer
55188MedicaidND

Other names 1

  • Professional Hearing Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080310000105 ND Part B Supplier - Clinic/Group Practice 0749365195 Receives reassigned benefits from 4 practitioners
Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Locations

1400 37th Ave SW
Minot, ND 58701
Phone (701) 852-6565

315 Main St S
Ste 316
Minot, ND 58701
Phone (661) 949-0004

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1649216169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 37TH AVE. SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013956",
            "telephone_number": "701-852-6565",
            "fax_number": "701-838-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 37TH AVE. SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013956",
            "telephone_number": "701-852-6565",
            "fax_number": "701-838-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST AUDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "AUDIOLOGIST/PRESIDENT",
        "authorized_official_telephone_number": "701-852-6565",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55188",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Hearing Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Hearing Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.