Individual provider Active NPI

Kristy Michelle Menendez, M.A., CCC-A

  • Audiologist
  • Glen Dale, WV
National Provider Identifier
1699825208
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-0246 Issued in WV
Practice address
1307 Wheeling Ave
Glen Dale, WV 26038-1747
Phone
(304) 810-0812
Fax
(304) 810-0815
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-0246 WV Primary

Addresses

Primary practice location

1307 Wheeling Ave
Glen Dale, WV 26038-1747

Mailing address

499 Colliers Way
Weirton, WV 26062-5011
Phone (304) 723-1592

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000721 WV Practitioner - Qualified Audiologist 2567546310 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A-0246WVMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Oct 12, 2012 Accepting new patients
Menendez Audiology LLC Audiologist PastSince Jul 13, 2007 Accepting new patients

Locations

1307 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 810-0812

499 Colliers Way
Weirton, WV 26062
Phone (304) 723-1592

Organizations & group practices 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1699825208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625011",
            "telephone_number": "304-723-1592",
            "fax_number": "304-723-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381747",
            "telephone_number": "304-810-0812",
            "fax_number": "304-810-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "KRISTY",
        "middle_name": "MICHELLE",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WV",
            "license": "A-0246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Dale, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.