Elks Hearing and Balance Center

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AUD-2112 Issued in ID

Legal business name

ELKS HEARING AND BALANCE CENTER

Practice address

520 S Eagle Rd
Suite 1225
Meridian, ID 83642-6351

Phone

(208) 489-5999

Fax

(208) 888-2496

NPI assigned

Dec 16, 2011

Organization subpart

Yes

Parent organization

IDAHO ELKS REHABILITATION HOSPITALAs reported in NPPES

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

Authorized official

Name

Mr. Michael Sturmak, M.S., CCC-A, F-AAA

Title

Chief Operating Manager

Phone

(208) 489-4975

Specialties & licenses 1

Addresses

Part of

Idaho Elks Rehab Hospit

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1659640860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "SUITE 1225",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426351",
            "telephone_number": "208-489-5999",
            "fax_number": "208-888-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "SUITE 1225",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426351",
            "telephone_number": "208-489-5999",
            "fax_number": "208-888-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKS HEARING AND BALANCE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDAHO ELKS REHABILITATION HOSPITAL",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "STURMAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF OPERATING MANAGER",
        "authorized_official_telephone_number": "208-489-4975",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., CCC-A, F-AAA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "ID",
            "license": "AUD-2112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Meridian, ID
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• Audiologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.