Organization Active NPI

TC Audiology LLC

Doing business as TC Audiology

  • Audiologist
  • Olivia, MN
National Provider Identifier
1689086167
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
9024 Issued in MN
Legal business name
TC AUDIOLOGY LLC
Doing business as
TC Audiology
Practice address
600 E Park Ave Ste 2
Olivia, MN 56277-1370
Phone
(320) 523-3435
Fax
(320) 323-4374
NPI assigned
Jun 2, 2014
Last updated
Jun 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Authorized official

Name
Rebecca Thiesse, AU.D.NPI 1619303682
Title
Audiologist/Owner
Phone
(320) 523-3435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 9024 MN Primary

Addresses

Primary practice location

600 E Park Ave Ste 2
Olivia, MN 56277-1370

Mailing address

611 E Fairview Ave
Olivia, MN 56277-4213
Phone (320) 523-1085

Other identifiers 1

IdentifierTypeStateIssuer
1619303682OtherMNNPI

Other names 1

  • TC Audiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140711001719 MN Part B Supplier - Clinic/Group Practice 1052536760 Receives reassigned benefits from 1 practitioner
Practice locations: Olivia, MN

National Provider Directory

National Provider Directory

Locations

600 E Park Ave
#2
Olivia, MN 56277
Phone (320) 523-3435

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1689086167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E FAIRVIEW AVE",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562774213",
            "telephone_number": "320-523-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E PARK AVE STE 2",
            "city": "OLIVIA",
            "state": "MN",
            "postal_code": "562771370",
            "telephone_number": "320-523-3435",
            "fax_number": "320-323-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TC AUDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "THIESSE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "AUDIOLOGIST/OWNER",
        "authorized_official_telephone_number": "320-523-3435",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "9024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619303682",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TC Audiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TC Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olivia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.