Individual provider Active NPI

Susan J Hansborough, AUDIOLOGIST

  • Audiologist
  • Fishersville, VA
National Provider Identifier
1689636318
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201000144 Issued in VA
Practice address
243 Woodrow Wilson Ave
Credentialing
Fishersville, VA 22939
Phone
(540) 332-7087
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201000144 VA Primary
Audiologist-Hearing Aid Fitter 237600000X 2101000806 VA

Addresses

Primary practice location

243 Woodrow Wilson Ave
Credentialing
Fishersville, VA 22939

Mailing address

PO Box 1500, Box W-1
Credentialing
Fishersville, VA 22939
Phone (540) 332-7087

Other identifiers 2

IdentifierTypeStateIssuer
004980107MedicaidVA
009451528MedicaidVA

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

LicenseStateTypeSpecialty
3888SCMDCounselor
2201000144VAMDAudiologist
2101000806VAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Audiology Associates PC Audiologist PastSince Jun 16, 1994 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1689636318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500, BOX W-1",
            "address_2": "CREDENTIALING",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "22939",
            "telephone_number": "540-332-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 WOODROW WILSON AVE",
            "address_2": "CREDENTIALING",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "22939",
            "telephone_number": "540-332-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSBOROUGH",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201000144",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2101000806",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004980107",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009451528",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.