Active NPI
Thomas Zachary Burkle, AU.D.
- Audiologist
- Fort Wayne, IN
National Provider Identifier
1699985275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 23002551A
- Practice address
- 4720 E State Blvd
Fort Wayne, IN 46815-6923 - Phone
- (260) 471-5693
- Fax
- (260) 471-4942
- NPI assigned
- May 23, 2007
- Sex
- Male
- 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 | 23002551A | IN | Primary |
Addresses
Primary practice location
4720 E State Blvd
Fort Wayne, IN 46815-6923
Mailing address
4720 E State Blvd
Fort Wayne, IN 46815-6923
Phone (260) 471-5693
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 |
|---|---|---|---|
| 23002551A | IN | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpaca Audiology - in & VA LLC | 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
- Fort Wayne, IN
- NPI 1164066478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462147200000",
"number": "1699985275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4720 E STATE BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156923",
"telephone_number": "260-471-5693",
"fax_number": "260-471-4942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4720 E STATE BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156923",
"telephone_number": "260-471-5693",
"fax_number": "260-471-4942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKLE",
"first_name": "THOMAS",
"middle_name": "ZACHARY",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2016-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IN",
"license": "23002551A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.