Organization Active NPI

Legacy Audiology

  • Audiologist
  • Rock Springs, WY
National Provider Identifier
1699553578
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
LEGACY AUDIOLOGY
Doing business as
Legacy Audiology
Practice address
1038 Cypress Cir
Rock Springs, WY 82901-4100
Phone
(307) 371-0789
NPI assigned
Sep 20, 2023
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Libby Mehle, AUDNPI 1447609193
Title
Co-Ower/ Audiologist
Phone
(307) 371-0789

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 NU Primary

Addresses

Primary practice location

1038 Cypress Cir
Rock Springs, WY 82901-4100

Mailing address

1208 Hilltop Dr Ste 105
Rock Springs, WY 82901-5858
Phone (307) 522-5410

Other names 1

  • Legacy Audiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231025002656 WY Part B Supplier - Clinic/Group Practice 0749636819 Receives reassigned benefits from 1 practitioner
Practice locations: Rock Springs, WY

National Provider Directory

National Provider Directory

Locations

1208 Hilltop Dr
Ste 105
Rock Springs, WY 82901
Phone (307) 382-8644

Practitioners & affiliated clinicians

Practitioners 1

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": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1699553578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 HILLTOP DR STE 105",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015858",
            "telephone_number": "307-522-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 CYPRESS CIR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014100",
            "telephone_number": "307-371-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY AUDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "MEHLE",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_title_or_position": "CO-OWER/ AUDIOLOGIST",
        "authorized_official_telephone_number": "307-371-0789",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Audiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legacy Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.