Organization Active NPI

Humboldt Audiology, PC

  • Audiologist
  • Eureka, CA
National Provider Identifier
1669684155
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
HUMBOLDT AUDIOLOGY, PC
Practice address
831 Harris St Ste D
Eureka, CA 95503-4541
Phone
(707) 443-7111
Fax
(707) 443-7117
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Ms. Emily A. Weber, MA
Title
Practice Manager
Phone
(707) 443-7111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

831 Harris St Ste D
Eureka, CA 95503-4541

Mailing address

831 Harris St Ste D
Eureka, CA 95503-4541
Phone (707) 443-7111

Other identifiers 1

IdentifierTypeStateIssuer
AU0023640MedicaidCA

Other names 1

  • Humboldt Audiology Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130513000536 CA Part B Supplier - Clinic/Group Practice 6204073166 Receives reassigned benefits from 1 practitioner
Practice locations: Eureka, CA

National Provider Directory

National Provider Directory

Locations

831 Harris St
Ste D
Eureka, CA 95503
Phone (707) 443-7111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1669684155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 HARRIS ST STE D",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034541",
            "telephone_number": "707-443-7111",
            "fax_number": "707-443-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 HARRIS ST STE D",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034541",
            "telephone_number": "707-443-7111",
            "fax_number": "707-443-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT AUDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "707-443-7111",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU0023640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humboldt Audiology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.