Active NPI
Maria Christina Childress, AU.D.
- Audiologist
- Champaign, IL
National Provider Identifier
1659847374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147000944
- Practice address
- 809 N Neil St
Champaign, IL 61820-3058 - Phone
- (217) 355-1214
- NPI assigned
- Oct 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 147000944 | IL | Primary |
Addresses
Primary practice location
809 N Neil St
Champaign, IL 61820-3058
Mailing address
2203 Aspen Dr
Champaign, IL 61821-6274
Phone (217) 898-0790
Other names 1
- Dr. Tina Childress
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147000944 | IL | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1659847374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2203 ASPEN DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618216274",
"telephone_number": "217-898-0790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 N NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203058",
"telephone_number": "217-355-1214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDRESS",
"first_name": "MARIA",
"middle_name": "CHRISTINA",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-19",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IL",
"license": "147000944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TINA",
"last_name": "CHILDRESS",
"prefix": "DR.",
"code": "5",
"type": "Other Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.