Individual provider Active NPI

Lisa K Christensen, MS, CCC-A

  • Audiologist
  • Ogden, UT
National Provider Identifier
1720076565
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
336324-4101 Issued in UT
Practice address
5275 S. Adams Ave. Pkwy.
B
Ogden, UT 84405-6748
Phone
(801) 394-4399
Fax
(801) 394-5003
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 336324-4101 UT Primary

Addresses

Primary practice location

5275 S. Adams Ave. Pkwy.
B
Ogden, UT 84405-6748

Mailing address

5275 S. Adams Ave. Pkwy.
B
Ogden, UT 84405-6748
Phone (801) 394-4399

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041118000856 UT Practitioner - Qualified Audiologist 5991769978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5275 Adams Ave Pkwy
Suite B
Ogden, UT 84405-6748

5275 S 500 E B
Ogden, UT 84405-6748

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336324-4101UTMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Professionals LC Audiologist CurrentSince Jul 1, 2012 Accepting new patients
Ear Technology Inc. PastSince Apr 6, 2001 Accepting new patients

Locations

5275 Adams Avenue Pkwy
Ste B
Ogden, UT 84405
Phone (801) 394-4399

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1720076565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 S. ADAMS AVE. PKWY.",
            "address_2": "B",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056748",
            "telephone_number": "801-394-4399",
            "fax_number": "801-394-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 S. ADAMS AVE. PKWY.",
            "address_2": "B",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056748",
            "telephone_number": "801-394-4399",
            "fax_number": "801-394-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "LISA",
        "middle_name": "K",
        "credential": "MS, CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "336324-4101",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.