Organization Active NPI

Knisely Aud, LLC

Doing business as Knisely Audiology Services

  • Audiologist-Hearing Aid Fitter
  • Everett, PA
National Provider Identifier
1689260507
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
Legal business name
KNISELY AUD, LLC
Doing business as
Knisely Audiology Services
Practice address
202 Memorial Dr Ste 3
Everett, PA 15537-7057
Phone
(814) 623-5007
NPI assigned
Dec 15, 2020
Last updated
Dec 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
Dr. Tessa A Knisely, AUDNPI 1588180160
Title
Owner/Audiologist
Phone
(814) 937-3485

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-Hearing Aid Fitter 237600000X NU Primary

Addresses

Primary practice location

202 Memorial Dr Ste 3
Everett, PA 15537-7057

Mailing address

187 Slate Dr
East Freedom, PA 16637-8945
Phone (814) 937-3485

Other practice location 1

800 S Logan Blvd Ste 3100
Hollidaysburg, PA 16648-3050
Phone (814) 946-5151

Other practice location 2

214 Peach Orchard Rd
Mc Connellsburg, PA 17233-8559
Phone (717) 485-6110

Other identifiers 1

IdentifierTypeStateIssuer
1034157180001MedicaidPA

Other names 1

  • Knisely Audiology Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210125001976 PA Part B Supplier - Clinic/Group Practice 4688088115 Receives reassigned benefits from 3 practitioners
Practice locations: Everett, PA; Hollidaysburg, PA; MC Connellsburg, PA

National Provider Directory

National Provider Directory

Locations

202 Memorial Dr
Ste 3
Everett, PA 15537
Phone (814) 623-5007

Practitioners & affiliated clinicians

Practitioners 7

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": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1689260507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 SLATE DR",
            "city": "EAST FREEDOM",
            "state": "PA",
            "postal_code": "166378945",
            "telephone_number": "814-937-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 MEMORIAL DR STE 3",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377057",
            "telephone_number": "814-623-5007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 S Logan Blvd Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Hollidaysburg",
            "state": "PA",
            "postal_code": "166483050",
            "country_code": "US",
            "telephone_number": "814-946-5151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "214 Peach Orchard Rd",
            "address_purpose": "LOCATION",
            "city": "Mc Connellsburg",
            "state": "PA",
            "postal_code": "172338559",
            "country_code": "US",
            "telephone_number": "717-485-6110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KNISELY AUD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "KNISELY",
        "authorized_official_first_name": "TESSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/AUDIOLOGIST",
        "authorized_official_telephone_number": "814-937-3485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034157180001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "202 Memorial Dr Ste 3",
            "city": "Everett",
            "state": "PA",
            "country_code": "US",
            "postal_code": "155377057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Knisely Audiology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.