Organization Active NPI

Pure Audiology LLC

  • Audiologist
  • Williston, VT
National Provider Identifier
1720530496
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
PURE AUDIOLOGY LLC
Practice address
64 Knight LN
Williston, VT 05495-9480
Phone
(802) 318-0138
Fax
(866) 649-2238
NPI assigned
Oct 28, 2016
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Dr. Christina JB Bradford, AU.D.NPI 1104114461
Title
President and Ceo
Phone
(802) 318-0138

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 VT Primary

Addresses

Primary practice location

64 Knight LN
Williston, VT 05495-9480

Mailing address

PO Box 186
Williston, VT 05495-0186
Phone (802) 318-0138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170425001927 VT Part B Supplier - Clinic/Group Practice 4082991286 Receives reassigned benefits from 1 practitioner
Practice locations: Williston, VT

National Provider Directory

National Provider Directory

Locations

64 Knight Ln
Williston, VT 05495
Phone (802) 318-0138

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": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1720530496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054950186",
            "telephone_number": "802-318-0138",
            "fax_number": "866-649-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 KNIGHT LN",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959480",
            "telephone_number": "802-318-0138",
            "fax_number": "866-649-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE AUDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "JB",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "802-318-0138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.