Active NPI
Kristy Michelle Menendez, M.A., CCC-A
- Audiologist
- Glen Dale, WV
National Provider Identifier
1699825208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A-0246
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-0246 | WV | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Distribution, LLC | Current | Accepting new patients | |
| Menendez Audiology LLC | Audiologist | Past | 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.
-
- Audiologist
- Weirton, WV
- NPI 1073707022
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.