Active NPI
Susan J Hansborough, AUDIOLOGIST
- Audiologist
- Fishersville, VA
National Provider Identifier
1689636318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2201000144
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004980107 | Medicaid | VA | |
| 009451528 | Medicaid | VA |
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 |
|---|---|---|---|
| 3888 | SC | MD | Counselor |
| 2201000144 | VA | MD | Audiologist |
| 2101000806 | VA | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Augusta Audiology Associates PC | Audiologist | 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 and National Provider Directory roles.
-
- Audiologist
- Fishersville, VA
- NPI 1497950919
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.