NPIMap

Individual provider Active NPI

Kent J Nielsen, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Ogden, UT
National Provider Identifier
1689744138
Registry record updated Aug 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
108649-4101 Issued in UT
Practice address
3651 Wall Ave
Newgate Mall
Ogden, UT 84405-2014
Phone
(801) 612-0202
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 108649-4101 UT Primary

Addresses

Primary practice location

3651 Wall Ave
Newgate Mall
Ogden, UT 84405-2014

Mailing address

70 S Fairfield Rd Ste 10
Layton, UT 84041-4495
Phone (801) 294-6200

Other identifiers 7

IdentifierTypeStateIssuer
10864941003001OtherUTBLUE CROSS BLUE SHIELD
80601OtherUTPEHP
PRO7581OtherUTMOLINA
1689744138MedicaidUT
10864941004001OtherUTBLUE CROSS BLUE SHIELD
224962OtherUTALTIUS
10864941006001OtherUTBLUE CROSS BLUE SHIELD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robinson Audiology, LLC. Audiologist-Hearing Aid Fitter Past Accepting new patients
Hearing Zone Inc Audiologist-Hearing Aid Fitter Past Accepting new patients
Lakeside Audiology LLC Audiologist-Hearing Aid Fitter Past Accepting new patients

Organizations & group practices 3

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1689744138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S FAIRFIELD RD STE 10",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414495",
            "telephone_number": "801-294-6200",
            "fax_number": "801-497-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 WALL AVE",
            "address_2": "NEWGATE MALL",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844052014",
            "telephone_number": "801-612-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "KENT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "UT",
            "license": "108649-4101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10864941003001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "80601",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PRO7581",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689744138",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10864941004001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "224962",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE  SHIELD",
            "identifier": "10864941006001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.