Active NPI
Gary Wyatt Andrus, AU.D.
- Audiologist
- Ukiah, CA
National Provider Identifier
1679680417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU902
- Practice address
- 1165 S Dora St Ste B2
Ukiah, CA 95482-6353 - Phone
- (707) 468-0400
- Fax
- (707) 468-8240
- NPI assigned
- Aug 25, 2006
- Last updated
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU902 | CA | Primary |
| Audiologist-Hearing Aid Fitter | 237600000X | HA2025 | CA |
Addresses
Primary practice location
1165 S Dora St Ste B2
Ukiah, CA 95482-6353
Mailing address
1165 S Dora St Ste B2
Ukiah, CA 95482-6353
Phone (707) 468-0400
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU902 | CA | MD | Audiologist |
| HA2025 | CA | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gary Wyatt Andrus | Audiologist-Hearing Aid Fitter | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1679680417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1165 S DORA ST STE B2",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826353",
"telephone_number": "707-468-0400",
"fax_number": "707-468-8240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1165 S DORA ST STE B2",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826353",
"telephone_number": "707-468-0400",
"fax_number": "707-468-8240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRUS",
"first_name": "GARY",
"middle_name": "WYATT",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU902",
"primary": true
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "CA",
"license": "HA2025",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.