Individual provider Active NPI

Lynn V Harris, AUD CCC SPA

  • Audiologist
  • Missoula, MT
National Provider Identifier
1730116542
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
432 Issued in MT
Practice address
1515 S Reserve St Ste 110
Missoula, MT 59801-4755
Phone
(406) 926-1969
Fax
(406) 926-1970
NPI assigned
Jun 27, 2006
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 432 MT Primary
Speech-Language Pathologist 235Z00000X 432 MT
Audiologist-Hearing Aid Fitter 237600000X 135 MT

Addresses

Primary practice location

1515 S Reserve St Ste 110
Missoula, MT 59801-4755

Mailing address

1515 S Reserve St Ste 110
Missoula, MT 59801-4755
Phone (406) 926-1969

Other identifiers 1

IdentifierTypeStateIssuer
0530995MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101108000193 MT Practitioner - Qualified Audiologist 8628122082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Montana Hearing and SpeechGroup PAC ID 9335549013, 2 clinicians

Practice addresses (Care Compare)

1515 S Reserve St
Suite 110
Missoula, MT 59801-4755
Phone (406) 926-1969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135MTMDSpeech-Language Pathologist
432MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western Montana Hearing and Speech Audiologist CurrentSince Feb 8, 2021 Accepting new patients
Western Montana Clinic PC Current Accepting new patients

Locations

1515 S Reserve St
Ste 110
Missoula, MT 59801
Phone (406) 926-1969

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1730116542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S RESERVE ST STE 110",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014755",
            "telephone_number": "406-926-1969",
            "fax_number": "406-926-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S RESERVE ST STE 110",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014755",
            "telephone_number": "406-926-1969",
            "fax_number": "406-926-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LYNN",
        "middle_name": "V",
        "credential": "AUD CCC SPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-06-17",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MT",
            "license": "432",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "432",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MT",
            "license": "135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0530995",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.