Kimberly J Andresen, AU.D CCC-A

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

288 Issued in NE

Practice address

2421 West Faidley Avenue
Grand Island, NE 68803-4328

Phone

(308) 384-2101

Fax

(308) 381-4787

NPI assigned

Jul 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Hearing Clinic IncGroup PAC ID 4385714120, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Hearing Clinic, Inc.

  • Audiologist-Hearing Aid Fitter
  • Grand Island, NE
  • NPI 1881722981
  Medicare reassignment Care Compare group NPD
• Audiology Hearing Aid Associates, Inc.

  • Audiologist
  • Lynchburg, VA
  • NPI 1821098062
  NPD (past)
• Danny W Gnewikow PH D LLC

  • Audiologist
  • Danville, VA
  • NPI 1679573802
  NPD (past)

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1679573794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 WEST FAIDLEY AVENUE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034328",
            "telephone_number": "308-384-2101",
            "fax_number": "308-381-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 WEST FAIDLEY AVENUE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034328",
            "telephone_number": "308-384-2101",
            "fax_number": "308-381-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRESEN",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "AU.D CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001204",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NE",
            "license": "288",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NE",
            "license": "108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-LYNCHBURG",
            "identifier": "P00014101",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47073801200",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY PHYSICIAN CARE-DA",
            "identifier": "540964595",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY PHYSICIAN CARE-LY",
            "identifier": "541361858",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025275800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OF VA - LYN",
            "identifier": "463627",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIEDMONTCOMMUNITYHLTHPLAN",
            "identifier": "541361858",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9451510",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-DANVILLE",
            "identifier": "P00014119",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OF VA - DANVILLE",
            "identifier": "248044",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9451501",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen Katherine Anderson
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• Rylie Anderson
• Steve F Anderson, DDS
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• Suellen Anson
• Vicki Anson, PLMHP

• Audiologist-Hearing Aid Fitter in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Audiologist-Hearing Aid Fitter in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.